Cardiopulmonary Bypass in Nursing Practice: Clinical Management, Patient Safety, and Perioperative Care
Abstract
Background: Cardiopulmonary bypass (CPB) enables complex intracardiac surgery by temporarily substituting heart and lung function with an extracorporeal circuit, creating a motionless, blood-reduced field while maintaining systemic perfusion and oxygenation. Its benefits are counterbalanced by inflammatory activation, coagulopathy, and multisystem risks that demand meticulous perioperative management.
Aim: To outline CPB fundamentals and translate them into nursing practice—detailing clinical indications, equipment and roles, preparation, intraoperative technique, complications, and team-based strategies to enhance patient safety and outcomes.
Methods: Narrative synthesis of CPB physiology and workflow across the perioperative continuum, integrating device functions (pump, oxygenator, heat exchanger, reservoirs, cannulas, filters), anticoagulation protocols, cannulation strategies (central/peripheral; one-stage/two-stage; cavoatrial/bicaval), myocardial protection (antegrade/retrograde/ostial cardioplegia), and structured team roles.
Results: Effective CPB hinges on: (1) risk-informed patient selection; (2) standardized preparation (ACT targets, heparin resistance pathways); (3) precise cannulation and de-airing; (4) tightly controlled temperature, perfusion pressures, and blood chemistry; (5) vigilant nursing surveillance for bleeding, vasoplegia, neurologic, renal, and respiratory complications; and (6) disciplined, closed-loop communication among surgeons, anesthesiologists, perfusionists, nurses, and ICU teams.
Conclusion: CPB remains indispensable for coronary, valvular, congenital, and complex aortic surgery. Nursing practice is central to safety—operationalizing protocols, recognizing early deterioration, coordinating interventions, and ensuring error-resistant handoffs. Interprofessional standardization and continuous monitoring mitigate CPB’s physiologic burdens, translating technical capability into improved recovery trajectories.
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Authors
Copyright (c) 2025 Abdulmajeed Jahaz Alahmadi, Salman Fahad Alsharif, Norah Saad Almutairi, Sarah Hussain Kaabi, Bashayer Abdullah Alghamdi, Mohammed Abualqasem Ali Alameer, Abdul Wahab Muhammad Sahqi, Mashael Khallaf Qweaan Aldhafeeri, Afrah Muzil Noman Aldhafeeri, Rahmah Saleh Alfaras, Mada Saleh Alfaras, Mohammad Yahaya Thabet Mahdi
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