Term
| clamping above or below the renal arteries will cause more hemodynamic and myocardial instability? |
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Definition
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Term
| why does HTN occur after cross clamping? |
|
Definition
| increased afterload and SNS activation |
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Term
| how do you treat increased preload/afterload with cross clamping? |
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Definition
| low volume, nitro (preload), and nipride (afterload) |
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Term
| what will happen after the surgeon unclamps? how do you treat? |
|
Definition
| profound hypotension and shock, treat with fluids, pressors, hyperventilation, and staging of the unclamping |
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Term
| when your clamp is placed __________, blood can be rerouted from the redicular blood flow to other organs causing spinal cord ischemia. |
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Definition
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Term
| what are the only two definitive measures to prevent cord ischemia in aneurisym repair? |
|
Definition
| fast surgery and maintain normal cardiac function |
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Term
| what are the two most important methods to prevent renal problems in aneurysm repair? |
|
Definition
| maintain intravascular volume and normal cardiac function |
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Term
| how can you protect the spinal cord and other organs from ischemia during aneurysm cross clamping? |
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Definition
| hypothermia, maintain proximal HTN, drain CSF through lumbar drain, barbs, normoglycemia, keep clamp times <30-45 min |
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Term
| What are some strategies to improve outcomes during the aneurysm repair surgery? |
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Definition
| prehydrate prior to induction to prevent BP fluctuation, avoid tachy, slightly dry prior to clamping, dilators to reduce BP if it is > 20% normal, fluid and pressors prior to clamp release |
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Term
| what should you always be prepared for when doing a endovascular AAA stent? |
|
Definition
| conversion to a general and opening with a large blood loss |
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Term
| What is critical when doing AV fistula placement? |
|
Definition
| maintain BP to assure perfusion through the graft |
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|
Term
| When will you give heparin in a aneurysym repair? |
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Definition
| several minutes prior to cross clamping |
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