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Cardiopulmonary bypass (CPB) overview

Published: June 21, 2009. Updated: July 27, 2009

 

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Cardiopulmonary bypass (CPB) is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. The CPB pump itself is often referred to as a Heart-Lung Machine or Cardiac Pump.

Cardiac pump

The cardiac pump or cardiac bypass pump or heart-lung machine temporarily takes over the function of breathing and pumping blood for a patient. It generally has two parts, the pump and the aerator.

  • The pump is usually several motor-driven rollers that peristaltically massage a tube made of silicone rubber. The massage pushes the blood through the tubing.
  • The aerator varies, but usually is either a drip onto a sterile surface, or passage through a silicone-membrane simulated lung.

Cardiac pumps are most often used in heart surgery, so that a patient's heart can be disconnected from the body for longer than the twenty minutes or so it takes a prepared patient to die. Although unprepared patients get brain damage in three to four minutes, and patient can be prepared by cooling and drugs so that no damage will occur for twenty minutes or more. Cardiac pumps are also sometimes used to keep babies with birth defects alive, or to aerate bodies with transplantable organs.

Chronic use of cardiac pumps is contraindicated because the pressure profile of most practical pumps is believed to cause circulatory damage to the brain, especially in extended use. The pumps generate continuous pressure. When this pressure is set high enough to aerate tissues in the foot, it can easily damage tissue in the brain. Likewise, if set low enough to avoid damaging the brain, it often under-aerates some part of the body, such as the feet.


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