الفهرس 
DECLARATION
Operational definitionsOnly 14 pages are availabe for public view
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Abstract
Cardiopulmonary bypass (CPB) provides extracorporeal maintenance of respiration and circulation at hypothermic and normothermic temperatures. CPB permits the surgeon to operate on a quiet, or nonbeating, heart at hypothermic temperatures, thus facilitating surgery in an ischemic environment.
• CPB is associated with a number of profound physiologic perturbations. The central nervous system, kidneys, gut, and heart are especially vulnerable to ischemic events associated with extracorporeal circulation.
• Controversy regarding the optimal management of blood flow, pressure, and temperature during CPB remains. Perfusion should be adequate to support ongoing oxygen requirements; mean arterial pressures of more than 70 mmHg may benefit patients with cerebral and/or diffuse arthrosclerosis.
• The initiation and termination of CPB are key phases of a cardiac surgery procedure, but the anesthesiologist must remain vigilant throughout the entire bypass.
• CPB is a complex system that is vulnerable to accidents. Careful and constant communication among the anesthesiologist, surgeon, perfusionist, and nurse is critical for patient safety.
Nursing safety precautions for achieving perfusion safety included. Provide policies, procedures and processes that provide authorization and specific instructions for performing tasks in the safest and most effective manner, have safety devices like hand cranks, arterial line filters, bloodline pressure pump shut-off, independent flow meters and more on hand to prevent injury or accident, Use checklists to ensure consistency and completeness of tasks. For example, a checklist could be used to ensure the pump and all of its parts are available and operating properly before a procedure begins, keep documents on all personnel competency training, troubleshoot problems as they occur.
Therefore, the aim of this study is to assess intraoperative nursing safety precautions for cardiac surgery patients on cardiopulmonary bypass machine. A Descriptive research design was used to conduct this research. This study was carried out in cardiac surgery unit at Heart Hospital, Assuit University. The sample of this study Convenient sample of 60 adult male and female patients who presented to cardiothoracic unit for undergoing cardiac surgery using cardiopulmonary bypass machine were included in addition to 20 critical care nurses acts as cardiac perfusionist who are willing to participate in the study.
Three tools were used in this study. Tool I: - risk factors for complications assessment sheet. it consisted of four parts, part I which included the patient’s Profile, Part II included the assessment of preoperative hemodynamic and biomedical data, part III which included laboratory tests findings during preoperative period. Part IV involved assessment of intraoperative cardiopulmonary bypass machine data. Tool two: ” Adult cardiopulmonary bypass complications assessment sheet ”This part refers to assessment of possible complications due to cardiopulmonary bypass machine, including the assessment of; cardiac arrhythmias, bleeding, cardiac arrest, pulmonary dysfunction, Renal failure, Central nervous system complications and infectious complications. and Tool III ”nursing safety precautions assessment sheet ” This part was including assessment of nursing safety precautions during surgery for patients on cardiopulmonary bypass machine. For safe conduct of cardiopulmonary bypass machine, temperature management, anticoagulation, anesthesia and monitoring, ultrafilteration, acid base balance and weaning management through observation of nursing performance by a nursing performance check list of daily routine of care.