Cardiac Surgery Certification Exam Cardiopulmonary Bypass Techniques 1 — Questions and Answers
Question 1: What is the standard target activated clotting time (ACT) before initiating cardiopulmonary bypass?
- Greater than 400 seconds (Correct answer)
- Greater than 200 seconds
- Greater than 300 seconds
- Greater than 150 seconds
Correct answer: Greater than 400 seconds
An ACT greater than 400 seconds is required before initiating CPB to prevent clot formation in the bypass circuit.
Question 2: Which cannulation site is most commonly used for arterial return during standard cardiopulmonary bypass?
- Ascending aorta (Correct answer)
- Femoral artery
- Axillary artery
- Carotid artery
Correct answer: Ascending aorta
The ascending aorta is the most common arterial cannulation site for CPB because it provides optimal flow and avoids retrograde perfusion risks.
Question 3: What is the purpose of the cardiotomy reservoir in the CPB circuit?
- To collect blood suctioned from the operative field (Correct answer)
- To oxygenate the blood
- To regulate systemic flow rate
- To warm or cool the perfusate
Correct answer: To collect blood suctioned from the operative field
The cardiotomy reservoir collects blood suctioned from the operative field so it can be filtered and returned to the patient.
Question 4: Which type of oxygenator is most commonly used in modern cardiopulmonary bypass circuits?
- Hollow-fiber membrane oxygenator (Correct answer)
- Bubble oxygenator
- Rotating disk oxygenator
- Screen oxygenator
Correct answer: Hollow-fiber membrane oxygenator
Hollow-fiber membrane oxygenators are preferred in modern CPB because they minimize blood trauma and air emboli risk.
Question 5: What is the typical target mean arterial pressure (MAP) during cardiopulmonary bypass for most adult patients?
- 50–80 mmHg (Correct answer)
- 30–40 mmHg
- 90–110 mmHg
- 20–30 mmHg
Correct answer: 50–80 mmHg
A MAP of 50–80 mmHg is generally maintained during CPB to ensure adequate end-organ perfusion while minimizing bleeding risk.
Question 6: Pulsatile flow during cardiopulmonary bypass is considered beneficial primarily because it:
- Improves microcirculatory perfusion and reduces systemic vascular resistance (Correct answer)
- Decreases the risk of air embolism
- Allows lower heparin dosing
- Reduces the need for hemodilution
Correct answer: Improves microcirculatory perfusion and reduces systemic vascular resistance
Pulsatile perfusion during CPB enhances microcirculatory flow and helps maintain normal vascular tone compared to non-pulsatile flow.
Cardiac Surgery Certification Exam Cardiopulmonary Bypass Techniques 1
What is the standard target activated clotting time (ACT) before initiating cardiopulmonary bypass?