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PRE-BYPASS 00:00
📡 Patient Monitor OFF BYPASS
ECG
ART
HR
68
bpm
MAP
76
mmHg
CVP
8
mmHg
PAP
24
mmHg
SvO₂
75
%
ACT
118
sec
CORE
36.8
°C
CI
—
L/min/m²
DO₂
—
mL/min
DO₂i
—
mL/min/m²
O₂ER
—
%
PVR
—
WU
Urine Output
0
mL
⏱️ Case Timers
Pump
00:00
Clamp
00:00
Ischemia
since last CP
00:00
Circ Arrest
00:00
Reperfuse
00:00
Pump = on CPB · Clamp = aortic XC on (continuous) · Ischemia = time since cardioplegia stopped (resets when CP runs; use to remind surgeon for redose) · Circ Arrest = flow≈0 + ≤22°C · Reperfuse = after XC off / hot shot
🌡️ Myocardium
Myocardial Temperature XC 00:00
36.8
MYOCARDIAL °C
37.0
BLOOD °C
0.0
GRADIENT
Target 10–15 °C during cardioplegia • Give CP after cross-clamp to cool & arrest
Myocardial °C Blood °C Gradient (blood − myo)
🧪 ABG
pH
7.40
PaO₂
95
PaCO₂
40
BE
0.0
SaO₂
98
Hct
36
Hb
12.0
K⁺
4.0
Na⁺
140
iCa
1.15
Mg⁺⁺
1.8
Glu
118
Lac
1.2
Cl⁻
104
HCO₃
24
TRENDS (draws + auto samples) pH · PaO₂ · PaCO₂ · Hct · K⁺ · Lac
● pH ● PaO₂ ● PaCO₂ ● Hct ● K⁺ ● Lac
🧠 Cerebral Oximetry (NIRS) Baseline: 68% / 67%
Left
68%
Right
67%
During DHCA, ice packs slow the NIRS decline (cerebral topical cooling). Not a substitute for ACP when used.
NIRS trend (cerebral oximetry over time) PRO
Left (green) Right (blue) Baseline ‖ DHCA band ◆ Ice on
💉 Anesthesia Control
Isoflurane (MAC) 1.0%
CPP (MAP − CVP) 68 mmHg
Target: >60 mmHg
⚙️ Heart-Lung Machine
1000 mL
Normal
🩸 Cell Saver PRO Bowl: 0 mL · Paused
Processed RBC: 0 mL · Paused = bowl does not fill (sucker returns to reservoir)
🔌 Circuit & Cannulation
ArterialVenousHeart & great vessels
Cannulation guide
Select a case scenario to see recommended arterial and venous cannulation (size and site).
ALP
0
mmHg
VLP
0
mmHg
ΔP art
—
est.
No bubbles
⚙ Arterial Pump · Forward Flow
0.0L/min
Target CI 2.4 – 4.8 L/min · BSA 1.9 m²
Sweep
2.0 L
FiO₂
60%
H/C Temp
37.0°
🌀 VAVD
0 mmHg
Vacuum-assisted venous drainage · Typical −20 to −40 mmHg
Venous Clamp
CLOSED
Aortic X-Clamp
OFF
Give heparin and confirm ACT ≥ 400 before opening the venous clamp.
🩸 Pump Sucker (Cardiotomy)
Requires full-dose heparin
🌡️
Myocardial Temp during Cardioplegia
36.8 °C Not cooled
Target <15 °C for protection
OFF Coronary Circulation LAD RCA CS Antegrade: root → LAD/RCA · Retrograde: CS → myocardium
Aortic Root Pressure
— mmHg
Root Vent Status
VENT OFF
Volume Delivered
0 mL
VENT CONTROLS · Manual control — Aortic Root & LV Vents
💙 AORTIC ROOT VENT
Status: OFF
Use with antegrade cardioplegia
💜 LV VENT
Status: OFF
Prevents LV distension
Cardioplegia Additives
🔥 Hot Shot Components
💊 Interventions
Vasopressors / Inotropes
Vasodilators
Anticoagulation
💉 Heparin Management
Weight-based Heparin Dose
82 kg × 400 = 32,800 U
Total Heparin Given: 0 units
⚡ Electrolytes
🩸 Metabolic / Blood
⚡ Temporary Pacemaker PRO
Mode OFF
Rate 80 bpm
What do AAI / VVI / DDD mean?

AAI — paces the atrium when it doesn’t fire on time. Needs intact AV conduction so the impulse reaches the ventricles. Raises HR via atrial capture.

VVI — paces the ventricle only. Used when AV block prevents atrial impulses from conducting. Ventricular rate = set rate; no AV synchrony.

DDD — dual-chamber: can pace atrium and ventricle and track atrial activity to maintain AV synchrony. Closest to normal conduction for post-CPB epicardial wires.

In this sim, turning pacing ON restores organized electrical activity at the selected rate when the heart is slow or asystolic.

📹 Pump Run Recorder PRO
Idle — press Record during a case
Every 5s stores flow, MAP, HR, SvO₂, reservoir, ACT. Replay scrubs that timeline. Export = download file · Import = load file · Delete removes a saved run.
⚡ Training Events PRO unlocks full set
✅ Time-Out / Pre-Bypass Checklist
Pre-bypass: required before venous clamp · Wean items: available to all users
⛔ Venous clamp locked — complete time-out checklist
Wean / protamine
🧮 Blood Gas What-If PRO
Inject volume/electrolytes and see ABG respond
📋 Event Log
00:00Case loaded: James R. — 3-vessel CAD — elective CABG
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