UNIT – I

Hemodynamic Aspects

Perfusion flow, pressure, and resistance; distribution of blood flow among vascular beds during total heart-lung bypass. 

Metabolic Aspects

Oxygen needs and perfusion flow requirements; perfusion flow vs. oxygen uptake; acid-base balance; electrolyte and water balance; oxygen toxicity.

UNIT – II

Control of Adequacy of Perfusion

Ideal perfusion parameters; monitoring devices (e.g., flow meters, pressure transducers); techniques for real-time control.

UNIT – III

Effects of Perfusion on Organs

Impacts on brain, heart, lungs, kidney, liver, spleen, and other organs (e.g., coagulation, inflammation responses)

Hematological Problems

Blood prime and priming solutions; control of red blood cell (RBC) trauma from priming; hemolysis prevention.

UNIT – IV 

Induced Cardiac Arrest and Myocardial Protection

Physiological principles of cardiac arrest; morphology, function, and metabolism of the arrested heart; cardioplegia techniques (cold blood, potassium-based, modified cold prime solutions).

Hypothermia

Bloodstream cooling and peripheral/nerve cooling modes; effects on heart and circulation at low temperatures (e.g., 18᎓28°C).

UNIT – V

Assisted Circulation

Circulatory and metabolic support via partial heart-lung bypass; organ-specific effects; Biomedicus centrifugal pump applications.

Ventricular Assist Devices

Left Ventricular Assist Device (LVAD), Right Ventricular Assist Device (RVAD), Biventricular Assist Device (BIVAD); indications and management.

Intra-Aortic Balloon Pump (IABP)

Principles, timing, and troubleshooting for counter-pulsation support.

Autotransfusion and Cell Saver Techniques

Intraoperative blood recovery; processing and reinfusion protocols.