Monitoring during cardiopulmonary bypass

The main purpose of cardiopulmonary bypass (CPB) is to fulfill the functions of the heart or of both the heart and lungs, whose functions have been stopped in parallel with the application requirement and to keep patients alive until the heart and lungs function at full capacity again. While extracorporeal circulation (ECC) takes over heart and/or lung functions with full or partial circulatory and respiratory supports, the physiopathology of CPB requires very sensitive monitoring due to the biomechanical and biocompatible properties of ECC devices, the contact of blood with nonphysiological surfaces, and highly complex, dynamic, and variable ECC processes. In these critical processes, monitoring the vital functions of patients and applying the necessary interventions to all problems should be managed by a multidisciplinary team, including cardiac surgeon, cardiovascular anesthesiologist, and perfusionist. The main purpose of monitoring vital functions is to observe with full accuracy that end-organ perfusion and oxygenation are fully achieved. First, circulatory, respiratory, and coagulation monitoring should be provided to maintain ECC; second, vital functions of other organs such as kidney, brain, and metabolism should be monitored. Monitoring during ECC must be a multilevel, multivariate, and very dynamic process. By adding new parameters, continuous monitoring of several invasive or noninvasive parameters can be relatively practical for the entire team.