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Cardiothoracic surgeries which require use of a Heart Lung machine HLM are considered the most common operation performed since 1953 all over the world but mainly in North America and Europe Notwithstanding that new technologies and techniques are being added in HLM also new guidelines are introduced to safety operate cardiopulmonary bypass CPB Nevertheless some things remains constant These things consider the achievement of the required optimal perfusion during HLM and relationship between the optimal blood flow and perfusion pressure during CPB Even though more research papers are in favour of a minor superiority of the optimal flow requirements compared to the corresponding optimal BP blood pressure needs their role is fairly dependant on each other The usage of the current Blood Parameter Monitoring System 500 Terumo CDI helped with evolution of the perfusion technique Optimal perfusion now can be delivered and assessed but its results in real time while information from CDI such as lactate LAC venous oxygen saturation Sv02 and levels of Hb haemoglobin or haematocrit Hct can be used as a marker of optimal perfusion and contribute to the development of new guidelines in the future Changing the BF and the BP to achieve a balance between two demands of optimal o2 delivery to the patient and surgical visualisation is important Andersson 1994 If the SvO2 is 80 or above it is believed that the patient is being given more 02 than his body demands is and the perfusion is adequate
