Anaes Vivas · Vascular anaesthesia
Aortic cross-clamp physiology: clamp-on and clamp-off — viva
Structured oral examination station for aortic-cross-clamp-physiology.
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Study tools
Target exams
ANZCAFRCAEDAICABAFCAI
Prompt
MAP falls from 95 to 55 within 30 seconds of unclamp; ETCO2 rises; K 6.2.
Opening
State the one-line answer first: clamp-on raises afterload (output down 17% without vasodilation, 33% in controls); clamp-off drops SVR with washout — fill and press before the clamp moves.
[3] [4] [5]References6ShowHide
- [1]Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation, 1999.PMID 10477528
- [2]Devereaux PJ, Yang H, Yusuf S, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet, 2008.PMID 18479744
- [3]Gelman S The pathophysiology of aortic cross-clamping and unclamping. Anesthesiology, 1995.PMID 7717537
- [4]Gelman S, McDowell H, Varner PD, Pearson J The reason for cardiac output reduction after aortic cross-clamping. Am J Surg, 1988.PMID 3128132
- [5]Colson P, Ribstein J, Séguin JR, et al. Mechanisms of renal hemodynamic impairment during infrarenal aortic cross-clamping. Anesth Analg, 1992.PMID 1616156
- [6]Loggi S, Mininno N, Damiani E, et al. Changes in the sublingual microcirculation following aortic surgery under balanced or total intravenous anaesthesia: a prospective observational study. BMC Anesthesiol, 2019.PMID 30611197