Abiomed Automated Impella Controller Manual De Usuario página 28

IMPELLA 2.5, IMPELLA 5.5 WITH SMARTASSIST,
IMPELLA CP WITH SMARTASSIST, OR IMPELLA CP
CATHETER FULLY IN VENTRICLE
If the Impella 2.5, Impella CP, Impella CP with SmartAssist , or Impella
5.5 with SmartAssist Catheter is fully in the ventricle, the following alarm
appears:
Impella Position In Ventricle
In this situation, the placement screen will appear as shown in Figure 22.
Figure 22. Impella CP Catheter Fully in Ventricle (similar to Impella 2.5)
Note: The alarm action for Impella CP with SmartAssist and
Impella 5.5 with SmartAssist will differ from screen shown. Refer
to alarms table for correct action.
Note: Yellow Flow Rate
If the Automated Impella Controller detects incorrect or unknown
catheter position, or if placement monitoring is suspended, the
flow rate in the flow area appears in yellow as shown in Figure
22.
Actions to take:
1.
Under fluoroscopic or echocardiographic guidance, reduce the
P-level to P-2 and carefully pull back the Impella Catheter until the
aortic waveform signal is showing.
2. When you see the aortic waveform signal, pull the catheter back
an additional 4 cm.
With the Impella CP with SmartAssist and the Impella 5.5 with
SmartAssist, a repositioning guide is available when the "Impella in
Ventricle" alarm is triggered. Follow the Alarm text instructions to access
the guide.
REPOSITIONING GUIDE FOR IMPELLA CP WITH
SMARTASSIST AND IMPELLA 5.5 WITH SMARTASSIST
If fluoroscopy or other imaging guidance is not available and you receive
an "Impella Position In Ventricle" alarm, you can use the repositioning
guide to correct the position of the catheter across the aortic valve. The
repositioning guide provides information about the current position of the
catheter and the actions required to reposition it.
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USING THE REPOSITIONING GUIDE
Perform the following steps to use the repositioning guide.
1.
Reduce P-level to P-2.
2. Press the MENU soft button and select Repositioning
Guide using the selector knob.
3. Press the START soft button to initiate the repositioning
guide.
4.
Loosen the Touhy-Borst valve to unlock the Impella catheter prior
to repositioning.
Press the DONE soft button to continue.
Figure 23. Loosen the Tuohy-borst Valve.
5.
Pull the Impella Catheter slowly while monitoring for an aortic
placement signal waveform on the Automated Impella Controller
screen. When the placement signal shifts to aortic,
stop pulling the Impella Catheter.
6.
Press the DONE soft button to continue.
Note: on Impella Position in Aorta
If the Impella catheter is pulled all the way into the aorta while in the
repositioning guide, an error screen will be shown. Follow the prompts on
the error screen and repositioning with appropriate imaging techniques.
Figure 24. Pulling Catheter Back Until Waveform Shifts to Aortic
7.
Using the centimeter markings on the catheter, pull the Impella
back slowly and additional 3 centimeters.
Press the DONE soft button to continue.
User Manual