Case Report

Normothermic Cardiopulmonary Bypass in the Larger Patient

^* Direct Communications to: Andrew Cleland, CCP, Clinical Perfusion Services, University Hospital-Room 2SU61, 339 Windermere Road. London. Ontario, Canada, N6A 5A5

Abstract

A 27 -year-old male patient presented for elective arrythmia surgery. Due to the nature of the surgical procedure, i.e. normothermic bypass, light anaesthetic, dislocation of the heart, etc., the physical size of this patient was of concern. The patient was 183 em tall and weighed 141 kg. The calculated body surface area was 2.68 M₂ and the calculated flow was 6.7 LPM. Because of the increased oxygen demands that are possible during arrythmia surgery, the ability of a single oxygenator to adequately transfer sufficient amounts of oxygen during all phases of the procedure was questioned. The decision was made to place two hollow fiber membrane oxygenators in line to prepare for the possibility of inadequate gas transfer. Both membranes were primed and de-aired as per our established protocol, after which the second membrane was isolated from the circuit. During the procedure our monitoring of serial blood gases and O₂ saturations demonstrated an oxygen deficit. The decision to utilize the second oxygenator was then made. The patient underwent a successful surgical oblation of a posteroseptal accessory pathway and was discontinued from cardiopulmonary bypass uneventfully.