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Inotropes and vasopressors

CPB is usually accompanied by hypothermia to < 32 C. Patients are usually warmed to at least 34 C before transfer to the ICU.

Effects of hypothermia

Predisposes to ventricular dysrhythmias and lowers VF threshold
Increases SVR; increases afterload and myocardial workload
Patient shivering causes increased peripheral O2 consumption
Decreases CO2 production; a patient who has a respiratory alkalosis (low PCO2) on initial ABG usually will increase their PCO2 with rewarming
Coagulopathy; impairs platelet function and the coagulation cascade. Rewarming is an important part of the treatment of a bleeding patient.
Patients are rewarmed using the “Bear Hugger”. This blows warm air over the body surface to warm by convection