Table 7 Intervention algorithm initiated by EEG slowing and/or cerebral venous oxygen desaturation. /: no change; +: increase; -: decrease; TCD: trans cranial doppler; CPB: cardio pulmonary bypass (From 25).
TEMPERATURE | BLOOD PRESSURE | TCD | NOTIFICATION | INTERVENTION |
|---|---|---|---|---|
Prebypass | ||||
/ | / | - peak velocity | Aorta obstructed | Adjust aortic cannula |
/ | / | - diastolic velocity | Cava obstructed | Asdjust venous cannula |
CPB | ||||
/ | / | + peak velocity | Hyperemia | - Pump flow |
/ | / | Gas emboli | Gas emboli | Deair, repair circuit |
+ | / | - peak velocity | Flow metabolism uncoupling | +BP; - metabolic demand |
/ | / | - peak velocity | Low cerebral flow | Adjust aortic cannula/clamp; + Pump flow |
Postbypass | ||||
/ | / | - Diastolic velocity | Cerebral edema | Mannitol; ultrafiltration |
Anytime | ||||
/ | - | - Peak velocity | Loss of autoregolation | + BP; neuroprotection |
+ EEG frequency | ||||
/ | /, + | /, + peak velocity | Insufficient sedation | + Sedation |