Warm (nasopharyngeal temperature of 37°C and core temperature of approximately 35.5°C) |
Anesthesia (most patients remain intubated and sedated with controlled postoperative mechanical ventilation) |
Adjuvant drugs (adequate supply of muscle relaxants, antiarrhythmic agents, inotropic agents, etc should be ready) |
Air (removed by ventilation and by massaging the heart, assisted by transesophageal echocardiography [TEE] visualization) |
Rhythm (normal sinus rhythm is ideal, but temporary epicardial pacing is employed if sinus rhythm cannot be achieved) |
Rate (heart rate between 80 to 90 beats/minute) |
Resistance (hypotension with normal or elevated bypass flow rate or cardiac output indicates low systemic vascular resistance and a need for vasopressors) |
Respiration (adequate ventilation and oxygenation) |
Metabolism (calcium [1.09 to 1.3 mmol/L], potassium [4 to 5.5 mmol/L], hemoglobin [≥7 mg/dL], acid–base status normalized) |
Monitoring (all monitors functioning and volume on pulse oximeter audible) |
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