加拿大多伦多总医院停体外循环处理模拟训练软件 - 新青年麻醉论坛

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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.