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1. Off-pump CABG: o Indications o Technique o Advantages/disadvantages 2. Heparin during CPB 3. Cardioplegia 4. Weaning from CPB 5. Complications after CPB and management 6. Common complications after CABG 7. Aortic cross-clamping: o Hemodynamic changes o Metabolic changes o Therapeutic interventions Give answer for dnb anaesthesia exam from millers consise 5 mark 10mark

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All seven topics are covered in exam-ready format. Here's how to use these answers:

Exam Strategy Tips for DNB

For 5-mark questions — write 3–4 focused points per subheading, use a table if listing multiple items, aim for ~250–300 words.
For 10-mark questions — use all three layers (mechanisms + clinical features + management), include a table, end with a management algorithm or mnemonic, aim for ~500–600 words.
High-yield points the examiner looks for:
  1. OPCAB — "porcelain aorta" + verticalization hemodynamics + 3% emergency conversion rate
  2. Heparin CPB — dose 300–400 U/kg, ACT target ≥480s, protamine reversal 1–1.3 mg/100U
  3. Cardioplegia — K⁺ 10–40 mEq/L diastolic arrest, cold, antegrade + retrograde routes, blood vs crystalloid
  4. Weaning — CVP mnemonic (Cold 36–37°C, Conduction HR 80–100, Ventilation, Pressures/inotropes)
  5. CPB complications — SIRS, neurological, renal, haematological + management ladder
  6. Post-CABG — AF (25–40%, amiodarone), graft ischaemia signs, chest closure hypotension
  7. Aortic clamp — On: ↑↑ afterload → esmolol + vasodilators; Off: ↓↓ SVR + acidosis → volume + vasopressors + gradual release
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