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ORAL QUESTIONS LIFE SUPPORT SYSTEM – 2021/22 Prof. Maria Laura Costantino Domanda su argomento a piacere + 2 domande della prof COUNTERPULSATOR (IAPB) Domanda a scelta Intra aortic balloon pump – reduce work heart improve the perfusion of the coronaries Catheter + balloon à fermoral artery up to descending aorta before the artic diramation Specific position in aortic arch depends on how much we want to perfuse upper districts Compressor + vacuum generator synchronized Diastole à inflation à P ventricole aorta increase à increase coronary perfusion Systole à deflation à flow blood à local depression + displacement à decrease P in LV aorta à work heart decreased Q constant Synchronized - Late def: increase P LV danger - Late inf: eff decreased - Prec def: eff decreased - Prec inf: increase P LV fluido dyn pb danger (less late def, P end systole lower) Cerebral perfusion in danger Invasive – couple weeks: - Balloon damage - Chances survival Gas used CO2: physiologically expelled in case of leakages Low density à pushed easy way inside the catheter à low R PAST ORAL QUESTIONS • ECMO Extra corporeal membrane oxygenator Blood side respiratory assistance System: membrane – tubes – pump – he – oxy – gas detector Configurations: VA – VV – central cannulation Central cannulation: RA Ao, cardiac support, babies Volemy: 800cc-1L vs 7L Memebrane: polymeric fibers, blood outside air inside, remix blood micro vortexes, selectively permeable controlled micoporosity 40-50A, silicone cont, polypropylene or polymetilpenthene porous Pump: centrifugal, 4 l/m hemolysis, divergent, flowmeter, gravitational drainage He before oxy, t increases affinity hb for oxy decreases No overoxygation Heparin Wash out of CO2, supply of O2 Problem of volemy vs priming volume • VV-ECMO VV: IVC(SVC) – pump –…