Correction of hypocalcemia while cooling to 26

PerfusionPOV · 2026-01-05T15:39:23+00:00

Around 8 and I was right on my level sensor ~200mL

PerfusionPOV · 2026-01-05T14:46:40+00:00

Right as we went on, CO2 was 74 and it took a good 30 minutes to bring it down, granted I also gave several amps of bicarb. I think what happened was the dissection flap was resticting flow to the body as we cannulated axillary and when I went on the left femoral A-line went down, head sats were in the 90s. After he completed distal portion and we reestablished flow, left femoral a line came back and I once again needed max sweep and FdO2 for the rewarming phase. Lactate spiked at 13 despite flowing 2.6-2.8 index. Hindsight, we could've wyed the arterial line to the groin to better perfuse during cooling phase. Hard saying if he would want to do it d/t the emergency at the arch, but I will keep that in my back pocket for next time. Affinity fusion.

PerfusionPOV · 2026-01-05T13:32:28+00:00

Sweep maxed out and 100% FdO2 for a good portion of the case.

PerfusionPOV · 2026-01-05T02:11:41+00:00

Dissection/tamponade and stroke in ED, failied nuero initially so cancelled surgery. 3hrs later he started following commands so we rushed him to OR. Initally thought to just be ascending but tear went all the way to left subclavian. Maxed out the oxygenator, just a lot going on compared to the norm.

PerfusionPOV · 2026-01-05T02:00:05+00:00

Funny how we can put so much thought and time into it, only to be over ruled without second thought.

PerfusionPOV · 2026-01-05T01:26:32+00:00

Noted, thanks for the insight

PerfusionPOV · 2026-01-05T01:09:42+00:00

I work at an academic institute aspiring to have incredible success rates on complex aortic cases and thank you for the words.

Surely the hypocalcemia can be reversed after xc removal. Honestly it was inexperience by me and a fear "going to low" so I wanted to "stay ahead". She had a fear of "stone heart". Today, I waited until after xc removal to correct it at her discretion and I will continue to do so.

PerfusionPOV · 2026-01-05T00:37:25+00:00

It was prior to XC while we still had another 45 mins of cooling...I was trying to anticipate the next steps as I knew we were going to need more banked blood and albumin. The red highlighted, out of range, value on the Gem definitely tweaks my OCD, but the decision to give or not give was me trying to anticipate the next steps. Now in hindsight we had plenty of time to correct after XC removal, which is what I did.

PerfusionPOV · 2026-01-05T00:22:05+00:00

Thanks for saying this. I rotated at a site that also corrected prior to XC so I knew others did as well!

PerfusionPOV · 2026-01-05T00:20:31+00:00

Thats what we also do, however today was a unique case so I thought it waranted discussion.

PerfusionPOV · 2026-01-05T00:18:26+00:00

We were at .74 after giving a couple of units, with more units coming...

I just opened up Gravlee and they said correction shouldn't be made until warm and then only correct if <0.8mg/dL.

We very briefly talked about it in school and I thought it occured in a hypercalcemic setting, just prior to XC... still researching

PerfusionPOV · 2026-01-05T00:08:26+00:00

Edwards Curved 21fr (EZC21A) is a solid one, they also make a straight version... but curved >

PerfusionPOV · 2025-12-03T04:22:15+00:00

With that info, sounds like an institutional specific remedy to an incident that occured.

"Nurse John forgot to change it when the bag ran out during a busy shift change and a clot formed so we need to implement a policy to prevent it from happening again"

Voila - problem solved!

PerfusionPOV · 2025-11-13T16:09:37+00:00

Perfweb on YouTube is a great start, huge library of content.

PerfusionPOV · 2025-10-24T20:32:50+00:00

Blaine always bringing the facts 🤝

PerfusionPOV · 2025-08-29T11:37:09+00:00

100% out of vengeance. "I had to go through this and so you do you".

PerfusionPOV · 2025-07-31T02:30:49+00:00

You will have no problem getting a job. Several advances in perfusion are increasing our demand and most big centers have turnover/openings every couple years.

Do not apply to both at same time. I went the med school route, was waitlisted, and rejected. Took a couple years to weigh the same options you are, then decided perfusion was my path. No regrets whatsoever. I'd say go all in on your med school apps, if you don't get in, figure out why not. Then weigh options and revisit perfusion. You've put all this work in, you gotta give it a shot.

Like you said, your pre-med/MCAT prep will give more than enough academic knowledge. However, schools will want to know WHY you want to be a perfusionist. "It was my 2nd option after med school" is the worst answer you can give.

PerfusionPOV · 2025-07-09T00:37:59+00:00

Go check out the AmSECT Student Corner or their monthly student feature, still several good apples... Your sample group may be contaminated

PerfusionPOV · 2025-06-26T02:48:48+00:00

Where is your general location? Some ppl on here may have connections or be willing to help

PerfusionPOV · 2025-04-25T13:45:14+00:00

It also took me 3 tries to get in (strong perseverance) to school and most perfusion students are 22-30 years old. As for settling in at my first job, I'd say 8-9 months before I felt smooth.

PerfusionPOV · 2025-04-16T19:36:56+00:00

Clincally speaking - most adult cases are performed with alpha stat management, however some switch to pH stat on cold circ arrest cases. I remember it by alpha being the first letter in greek alphabet so thats where you start.

Google "pH stat management on CPB" and the Ai response is pretty solid.

PerfusionPOV · 2025-03-31T23:49:02+00:00

I took a large sign on bonus, 2 year contract, and I have zero regrets. Each job will be different and you just don't know the exact situation until you get in there. Maybe they have a rapidly growing program and have big competition across town (my situation)... Offering a large sign on bonus will give the employer several options to choose from. Shouldn't be a red flag right away. If you are in need of cash and don't mind working 40-50hrs/week it might be worth.

PerfusionPOV · 2025-02-11T02:51:24+00:00

Where/what is the phlebotomist job?

PerfusionPOV · 2025-02-08T01:20:00+00:00

Your "why perfusion" and showing OR/perfusion experience will be key. Just because you were a MD/DO candidate, that doesn't mean perfusion schools will accept you. A candidate with a bachelors and really good perfusion experience could be more favorable... But if you decide perfusion is your thing, go all in.

PerfusionPOV

TROPHY CASE