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Before CPB (cardipulmanary Bypass) there is...

Normal hemodynamic physiology is illustrated in this first picture.
  • The top two WHITE lines are a patients electrocardiogram (ECG) which monitors the electrical activity of the patients heart. With every electrical conduction, there is mechanical contraction. This mechanical contraction causes blood to be ejected from your heart and into your arteries. This movement of blood is what you feel when you take your pulse on your wrist.
  • The RED line on the screen is a patients arterial blood pressure monitored from a catheter in their radial artery. You should note that it is normally pulsatile and in synch with the ECG. After being ejected into the arteries the blood goes out to the capillaries and eventually returns to the right side of the heart.
  • The BLUE and YELLOW lines on the screen illustrate the pressures in the right atrium and the pulmonary artery of the heart. You should note that they are normally positive.

Once the patient is placed on cardiopulmonary bypass, and the heart is stopped, you can see that there is:
  • no electrical activity (the WHITE ECG trace is "flatline")
  • arterial trace (RED line) is no longer pulsatile
  • right sided pressure tracings (BLUE and YELLOW) are essentially zero.

The patient is alive only because the cardiovascular perfusionist is providing blood flow and gas exchange with their specialized equipment.