Abiomed Automated Impella Controller Manual De Usuario página 33

PLACEMENT SIGNAL LUMEN
(FOR IMPELLA 2.5 & IMPELLA CP)
BACKGROUND
The Impella 2.5 and Impella CP Catheters use a fluid-filled pressure lumen
with an inlet at the proximal end of the motor housing and the pressure
sensor located in the red Impella plug. The Automated Impella Controller
software monitors both the pressure waveform characteristics and motor
current to determine the placement of the Impella Catheter inlet and outlet
areas relative to the aortic valve. Table 6 provides recommended standards
for maintaining the placement signal.
Note: Restoring Placement Signal Quality
You may get a sensor or position alarm if you pinch the white flush
valve to restore placement signal quality.
Table 6. Recommended Standards for Maintenance of the
Placement Signal for Impella 2.5 and CP Catheters
Slight dampening
Periodic
If you observe a dampened placement signal, pinch the
flushing of
white flush valve located on the red sidearm for a few
the placement
seconds to restore the placement signal quality.
signal lumen.
Note: Either of Severe or lost pressure
these actions may 1. Close the roller clamp and disconnect the IV tubing
result in sensor or connected to the red pressure sidearm.
position alarms. 2. Connect a syringe of saline to the port and squeeze
the white flow valve as you draw negative pressure.
3. Continue aspiration of the port until blood is
visualized in the syringe.
4. Disconnect the syringe and open the roller clamp
until slow drips of saline exit the tubing.
5. Flood the open port of the red pressure sidearm
and then reconnect.
6. Squeeze the white wings of the flow valve for 15 to
20 seconds to flush the pressure lumen to remove
all blood from the pressure lumen.
Pressure
Maintain pressure bag inflation pressure between
bag inflation
300 mmHg and 350 mmHg.
pressure
FLUSH SOLUTION CHANGE-OUT PROCEDURE
1. Prime the new NaCl flush solution set-up and close the roller
clamp.
2.
Place the NaCl bag in a pressure bag and inflate to between 300
mmHg and
350 mmHg.
3.
Close the roller clamp and disconnect the old flush solution
connected at the red sidearm port.
4.
Open the roller clamp on the new flush solution set-up until you
get a slow drip.
5. Position the male luer connector over the female luer connector
and fill to overflow, displacing any air, as shown in Figure 26.
6. Connect and secure luer fittings.
7.
Fully open the roller clamp and squeeze the white wings for
approximately 5 to 10 seconds to complete the internal prime. This
final prime should eliminate any risk of lost or dampened pressure
caused by blood tracking into the pressure lumen during the
pressure tubing change.
Automated Impella Controller with SmartAssist
Figure 32. Displacing Air During Flush Solution Change Out Procedure
PRESSURE SENSOR DRIFT AND PLACEMENT
SIGNAL NOT RELIABLE
(FOR IMPELLA 5.0 AND IMPELLA LD)
MANUALLY ZEROING THE DIFFERENTIAL PRESSURE
SENSOR
The electrical signal produced by the differential pressure sensor may drift
over time. If you observe that the placement waveform has shifted up or
down on the display, or the expected flow does not match the current
P-level setting, zero the differential pressure sensor by performing the
following steps:
1. Press the MENU key and select Start Manual Zero.
2.
Select OK to confirm the decrease in P-level.
3. The controller displays: Wait until the new P-level is
reached and then: Calculation is running.
4.
Select OK to accept the setting when the controller displays the
Placement Signal Offset Adjust finished!.
5.
The Impella automatically resets to the previous P-level.
ZEROING THE DIFFERENTIAL PRESSURE SENSOR WHEN
THE IMPELLA 5.0 CATHETER IS RUNNING
The controller software contains a data table listing the expected
differential pressure for a given motor current when the motor speed is set
to a specific value. To zero the differential pressure sensor while the Impella
5.0 Catheter is running, the software sets the motor speed and measures
the motor current. Using the data table, the software determines what the
measured differential pressure should be, then adjusts the signal from the
differential pressure sensor so that it matches the expected value.
PLACEMENT SIGNAL NOT RELIABLE AND EFFECTS ON
FLOW CALCULATIONS
If the pressure sensor fails, the controller can no longer calculate the
flow rate. The controller displays a Placement Signal Not Reliable
alarm. The placement screen displays a table with estimated flows and
corresponding MAPs in the bottom-left corner of the display. The Home
screen displays a yellow question mark over the heart icon and the text:
Placement Monitoring Suspended
To Silence this alarm, Go to > MENU and select > SETTINGS/SERVICE.
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