Review Note

Last Update: 01/29/2025 03:22 AM

Current Deck: ACG Part 2::Cardiac SSU

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Front
SS_CS 1.7 Describe an appropriate anaesthetic technique for the following cardiac surgical procedures including haemodynamic goals:
• Emergency Coronary artery bypass 
Back
Emergency CABG

Unsuccessful PCI with ongoing ischaemia, persistent ACS not amenable to PCI, coronary artery dissection following angio

Periop
  • Recent DAPT, high risk of bleeding
  • IV access as per cath lab +/- IABP
  • Consider awake CVL prior to induction for inotrope administration
  • Induction strategies:
    • Midazolam 5-10mg
    • Etomidate 0.05-0.2mg/kg
    • Ketamine 0.5-1mg/kg
    • Caution with fentanyl, reliant on sympathetic drive
  • Progression to CPB depending on patient haemodynamic stability
  • Low threshold for platelet transfusion, consider platelet mapping + TEG
  • Increased risk of inotropic or mechanical support postop

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