Priming And Recirculation Procedure; Initiating Bypass; Check The Correct Operation Of The Heat Exchanger - dideco D905 EOS ECMO Instrucciones De Uso

ref.8) is positioned next to the arterial outlet, while the venous
probe site (blue - fig.2, ref.9) is at the side of the venous inlet.
SORIN GROUP ITALIA temperature probes have the code
9026.
7) CLOSE THE RECIRCULATION LINE
Close the purging-recirculation stopcock (refer to the diagram
on the label) (fig.2, ref.10).
8) CONNECT THE GAS LINE
Remove the green cap from the connector labelled "GAS
INLET" (fig.2, ref.11) and connect the 1/4" gas line. The gas
should be supplied by a suitable air/oxygen mixer such as the
Bird code 9374 (available from SORIN GROUP ITALIA) or a
system with compatible technical features. A capnograph
connector can be found in the centre of the "GAS ESCAPE"
connector (fig.2, ref.12).
– The "GAS ESCAPE" system is designed to avoid any
possible risk of blocking the gas outlet; such blockage
could cause the immediate passage of air to the blood
compartment.
F. PRIMING AND RECIRCULATION
PROCEDURE
Do not use alcoholic priming solutions: such solutions
could compromise the proper functioning of the oxygenating
module.
1) KEEP THE GAS FLOW OFF
2) KEEP THE OXYGENATOR
PURGING/RECIRCULATION LINE CLOSED
Check that the purging-recirculation stopcock is closed (fig.2,
ref.10).
3) CLOSE THE VENOUS AND ARTERIAL LINES
Clamp the venous line coming from the patient. Clamp the
arterial line some centimetres from the arterial outlet.
Clamp the reservoir outlet.
4) CHECK THE HEAT EXCHANGER
Verify again the integrity of the heat exchanger, with particular
attention for possible water leaks.
5) RESERVOIR PRIMING
Fill the resrevoir with sufficient liquid to ensure the intended
haematocrit is obtained, taking into account:
– the static priming volume of the oxygenator is 160 ml;
– the 3/8" tube capacity is 72 ml/m;
the 1/2" tube capacity is 127 ml/m.
–
6) CIRCUIT PRIMING
– The pressure level inside the blood compartment of the
oxygenating module shall not exceed 100 KPa (1 bar / 14
PSI).
– The pressure difference between blood compartment
inlet and outlet shall not exceed 26 KPa (0,26 bar / 3,8
PSI).
Remove the pump segment (if present) from the arterial pump
head. Prime the pump segment by holding it height and slowly
open the clamp. Lower the line slowly to direct air to the
oxygenator. The oxygenating module priming is completed by
gravity. When the D905 EOS ECMO is primed, insert the pump
segment (if present) in the arterial pump.
7) OPEN VENOUS AND ARTERIAL LINES
Remove the clamp from the venous and arterial lines and
increase flow up to 1500 ml/min.
8) OPEN
STOPCOCK
Once the steps up to and including point 7 have been carried
out, increase the arterial pump speed until the flow reaches the
maximum value of 5.0 l/min. Open the purging recirculation
stopcock for some seconds in order to prime the oxygenator
recirculation line.
9) PURGE THE AIR FROM THE CIRCUIT
During this phase it is necessary to tap the entire circuit in
order to facilitate the removal of microbubbles from the tube
walls.
After some minutes in which the flow is maintained at a high
rate, all air will be evacuated.
10)
After 3-5 minutes of high flow recirculation/purge all the
residual air will be evacuated and the purging/recircualtion line
can be clamped.
Stop the arterial pump.
11)
– During the priming and purge phases, the arterial/venous
– Do not use pulsatile flow during priming.
– Check the correct dosage of anticoagulant in the system
– SORIN GROUP ITALIA recommends the use of the pump
– Do not use the pump on/off switch until the pump speed
– If the reduction connector (D523C) and a circuit have
– Clamp the line some centimetres away from the outlet.
– Do not create a negative pressure at the coronary outlet.
G. INITIATING BYPASS
1) OPEN THE ARTERIAL AND VENOUS LINES
Remove first the clamp from the arterial line, then remove the
clamp on the venous line. Start the bypass with a blood flow
appropriate to patient size.
2) CHECK THE CORRECT OPERATION OF THE
HEAT EXCHANGER
Check the temperature of the venous and arterial blood.
3) SELECTION OF THE APPROPRIATE GAS FLOW
The suggested gas/blood flow ratio in normothermia is 1:1 with
a Fi0 2 of 80:100%.
GB – ENGLISH – INSTRUCTIONS FOR USE
THE PURGING/RECIRCULATION
CLOSE THE PURGING/RECIRCULATION LINE
CLOSE THE VENOUS AND ARTERIAL LINES
circuit must be maintained at least 30 cm higher than the
arterial outlet of the oxygenator.
before starting the bypass.
speed control to reduce or stop the arterial flow slowly.
is zero.
been connected to the coronary outlet port, check the
priming of the connected line.
Negative pressure in the blood compartment could
cause microbubbles formation.
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