Priming And Recirculation Procedure; Initiating Bypass - dideco D 901 LILLIPUT 1 Instrucciones De Uso

"ON-OFF" manifold (position "ON").
7) SAMPLING MANIFOLD (fig. A)
It is possible to remove the LILLIPUT manifold from its position
and mount it on the appropriate holder (D 712). The tube coil
attached to the manifold allows it to be repositioned to a range of
approximately 1 metre.
Check that the selector switch (ref. 10) is in the "OFF" position.
8) CONNECTING THE TEMPERATURE PROBES
The connection for the arterial temperature probe (red - ref. 11)
is positioned next to the arterial outlet, whilst the venous probe
site (blue - ref. 12) is opposite the venous inlet.
SORIN GROUP ITALIA temperature probes have code 9026.
9) RECIRCULATION AND PURGE LINES
Check that the white clamp (ref. 13) positioned on the recircula-
tion line between arterial outlet of the oxygenating module and
venous reservoir is open. Close the blue clamp on the oxygena-
tor purge line.
10)CONNECTING THE GAS LINE
Remove the green cap from the gas inlet connector indicated as
"GAS INLET" (ref. 14) and connect the 1/4" gas line. Ensure that
the gas supply is from a suitable air/oxygen mixer such as the
Sechrist, code 9046 (available from SORIN GROUP ITALIA) or a
system with compatible technical features. A capnograph con-
nector can be found in the centre of the connector marked "GAS
ESCAPE" (ref. 15).
CAUTION
- 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.
- SORIN GROUP ITALIA recommends the use of a bubble trap
or filter on the arterial line to reduce the risk of emboli
transmission to the patient.
- If there is to be continuous administration of anticoagulant to
the patient, use a unfiltered female luer lock connector on
the head of the reservoir.
11)VAPOROUS ANAESTHESTICS
The oxygenator is suitable for use with volatile anaesthetic iso-
flurane and sevoflurane, by mean of a suitable narcosis gas eva-
porator.
If these vaporous anaesthetics are used, some method of sca-
venging the gas from the oxygenator should be considered.
The protocol, the concentration and the monitoring of the anae-
sthetic gases administrated to the patient, is under the sole
responsibility of the physician in charge of the treatment.
WARNING
The only volatile anaesthetics suitable for this use are isofluora-
ne and sevolfuorane
WARNING
The methods adopted for vaporous anaesthetic gas scavenging
should not increase or reduce in any way the pressure level at the
oxygenator fibres.
F. PRIMING AND RECIRCULATION PROCEDURE
WARNING
Do not use alcoholic priming solutions: such solutions could com-
promise the proper functioning of the oxygenating module.
1) KEEP THE GAS FLOW OFF
2) KEEP THE OXYGENATOR PURGE LINE CLOSED
Check that the blue clamp, placed on the oxygenator purge line,
is in the closed position. Keep the white clamp, placed on the
recirculation line, open.
3) ISOLATE THE RIGID VENOUS RESERVOIR FROM THE OXYGE-
NATING MODULE
Clamp the reservoir outlet "blood outlet" and the venous return.
Clamp the arterial line some centimetres from the oxygenator
arterial outlet.
4) CHECKING THE HEAT EXCHANGER
Verify again the integrity of the heat exchanger, with particular
attention to possible water leaks.
5) VENOUS RESERVOIR PRIMING
Secure with ties all aspiration lines connected to the cardiotomy
reservoir. Fill the cardiotomy reservoir with sufficient liquid to
ensure the intended haematocrit is obtained, taking into
account:
- the static priming volume of the oxygenator is 60 ml;
- the 3/16" tube capacity is 19 ml/m;
- the 1/4" tube capacity is 32 ml/m.
In order to fill the Venous Reservoir or if the Cardiotomy
Reservoir capacity is not enough (250 ml), open the connection
to the Venous Reservoir by rotating the connection key (ref. 3)
on the top of the Cardiotomy Reservoir.
6) CIRCUIT PRIMING
WARNING
- The pressure level inside the blood compartment of the oxy-
genating module shall not exceed 100 Kpa ( 1 bar / 14 psi).
Remove the clamp at the cardiotomy outlet.
Switch the arterial pump on to prime the oxygenating module.
In this condition, the blood recirculates between the oxygenator
and the venous reservoir; maximum flow shall not exceed 200
ml/min.
7) OPEN VENOUS AND ARTERIAL LINE
Remove the clamp from the venous and arterial line and increa-
se flow up to 800 ml/min.
8) CLOSING THE OXYGENATOR RECIRCULATION LINE
Close the white clamp placed on the recirculation line.
9) PURGING THE AIR CONTAINED IN 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) PRIMING OF THE SAMPLING MANIFOLD
The removal of the air from the A/V sampling system is achie-
ved by selecting the yellow A/V SHUNT position. If the arterial
pressure is not sufficient to remove the microbubbles from the
tube walls, squeeze gently the arterial line of the circuit so as to
partially close it.
11) OPENING THE RECIRCULATION LINE
After complete removal of air from the circuit, it is possible to
reduce the arterial flow to 200 ml/min opening the recirculation
line and performing recirculation.
12) CLOSING THE VENOUS AND ARTERIAL LINES
CAUTION
- Do not use pulsatile flow during priming.
- Check the correct dosage of anticoagulant in the system
before starting the bypass.
- SORIN GROUP ITALIA recommends the use of the pump
speed control to reduce or stop the arterial flow slowly.
- Do not use the pump on/off switch until the pump speed is
zero.
G.INITIATING BYPASS
1) OPENING OF 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.
Check constantly the blood level in the venous reservoir.
2) CHECKING THE CORRECT OPERATION OF THE HEAT
EXCHANGER
Check the temperature of the venous and arterial blood.
3) SELECTION OF THE APPROPRIATE GAS FLOW
3