Weaning from cardio-pulmonary bypass
Under development
Note: This module was developed with Adobe Flash, and Flash is no longer supported by web browsers. However, there is a new Flash emulator called Ruffle which is under development. Currently, the simulations of Post-operative Patient Care and Weaning from Cardiopulmonary bypass are the only PIE Flash module that works with Ruffle. Since Ruffle development is ongoing, future releases of Ruffle will work with other PIE modules. This will be indicated on the web page for each module.
Ruffle can be installed as an extension to the Chrome browser which will allow these modules to play. This extension can be downloaded from the Chrome Web Store:
Note: This Flash file is very large (10 MB) and takes time to load and be converted by the Ruffle extension. The Ruffle extension will prompt you to "Cancel" or "Wait" at least twice before it is ready to play. Please click "Wait" and be patient.
Open the Weaning Demonstration.
The challenge
This simulation will cover process of weaning of a patient from cardio-pulmonary bypass. The challenges to successful weaning will be depressed myocardial contractility, hypo or hypertension, hypo or hypervolemia, hypo or hyperthermia, and arrhythmias such as myocardial fibrillation and heart block. This simulation will occur in real time.
Your task
Your task will be to rewarm the patient and normalize the blood gases and electrolytes before reperfusing the heart. After reperfusion for the appropriate time, you will then gradually reduce the venous drainage and the pump flow until the patient’s heart rate, arterial blood pressure, central venous pressure, cardiac index and temperature are within acceptable clinical levels and maintain the patient's stability after the pump has been turned off for 5 minutes.
Interventions
You may treat the patient with the following interventions:
- Increase or reduce flow of the cardiopulmonary bypass pump
- Increase or reduce the venous return to the cardiotomy reservoir.
- Infusion medications
- Bolus medications
- Fluid replacement
- Warming or cooling the patient
- Defibrillation
- Cardiac pacing
Diagnostic information
- Vital signs from the patient monitor
- Visual indication of beating and filling of the heart in the sternotomy
- Fluid intake and output
- Cardiac index
Your score
You have 15 minutes of real time to accomplish the task of successfully weaning the patient from cardiopulmonary bypass.
