CCP Blood Conservation & Transfusion Strategies Flashcards

Conventional ultrafiltration (CUF) performed during CPB is used to:

Answer: Remove excess fluid and hemoconcentrate the patient during bypass

CUF removes excess water and small solutes across a semipermeable membrane during CPB, helping manage volume balance and hemoconcentrate the patient.

Which coagulation factor is most rapidly depleted during CPB due to hemodilution and consumption?

Answer: Fibrinogen

Fibrinogen is highly susceptible to dilutional loss and CPB-induced consumption, and its depletion is a major contributor to post-bypass coagulopathy.

Platelet dysfunction after CPB is primarily caused by:

Answer: Platelet activation and degranulation from contact with CPB circuit surfaces

Contact of platelets with the artificial surfaces of the CPB circuit causes activation, degranulation, and a qualitative functional defect even when platelet counts remain adequate.

Desmopressin (DDAVP) is used in cardiac surgery primarily to:

Answer: Release endogenous von Willebrand factor and factor VIII to improve platelet function

DDAVP stimulates endothelial release of stored von Willebrand factor and factor VIII, improving platelet adhesion especially in patients with qualitative platelet dysfunction.

A bloodless surgery program for Jehovah's Witness patients primarily relies on:

Answer: Preoperative optimization, cell salvage, and volume expanders to avoid allogeneic transfusion

Bloodless surgery programs combine preoperative erythropoietin/iron therapy, intraoperative cell salvage, meticulous hemostasis, and volume expanders to avoid all allogeneic blood products.

Thromboelastography (TEG) or rotational thromboelastometry (ROTEM) measures:

Answer: Whole blood viscoelastic clot formation, strength, and fibrinolysis in real time

TEG/ROTEM assesses viscoelastic properties of whole blood from clot initiation through fibrinolysis, enabling goal-directed transfusion therapy after CPB.