Cardiac recipe

For a ‘well patient’ of 70kg

Pre-med temazepam 10mg notce and mane

Standby:
Phenylepherine 100mcg/ml 20ml
Atropine 600mcg/ml
Phenylepherine 1mg/ml 10ml for perfusionist
CaCl 10% 10ml
MgSO4 50% 10ml

16G IVI
Awake arterial line

Antibiotics

Pre-O2
+/-Diazepam 10mg
Fentanyl 1mg (20ml of 50mcg/ml)
Etomidate 10-20mg (5-10ml of 2mg/ml) or propofol 50-100mg
Rocuronium 100mg (10ml of 5mg/ml)

ISO 0.5%
Tranexamic acid 1g
Propofol 1% at 10ml/hr

KTS:
MgSO4 5-10ml of 50% (500mg/ml or 2mmol/ml)
+/- Increase ISO up to 1%

Baseline ACT, ABG
Baseline ACT is 120-140sec

Have heparin ready. 400units/kg
OR, if using 1000units/ml then 0.4ml/kg or 2.5kg per ml or 50kg man = 20ml

ACT must be > 480 sec prior to bypass

Protamine for off-bypass
1mg per 100 units of heparin
4mg/kg
1ml heparin (1000iu/ml) = 1ml protamine (10mg/ml)

10mg morphine

On rewarming:
Noradrenaline 80mcg/ml @ 2ml/hr

Also need 50mg protamine per 500ml ‘pump blood’ transfused back.

CABG
+/- dobutamine

AVR
+/- GTN 1mg/ml

AA

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