Priming And Recirculation Procedure - dideco COMPACTFLO EVOLUTION Istrucciones Para El Uso

WARNING
- If a connection is made to the coronary outlet port during
bypass, the line to be connected must be unclamped and
unpressurised such that blood will flow into it upon
connection.
- Connect the recirculation line to one of the rear connectors
of the reservoir.
6) SAMPLING RAMP
The arterial/venous sampling ramp is supplied in a single sterility
bag integrated with about 1 m venous/arterial tubing lines.
ARTERIAL SAMPLING LINE: remove the protective cap from the
luer connector placed beside the arterial outlet (fig. 2, ref. 19).
Connect the male luer of the arterial sampling line of the ramp.
WARNING
Male luers not supplied with SORIN GROUP ITALIA products
may damage the one-way valve placed inside the oxygenator
arterial sampling luer. When connecting, make a visual check
that the male luer does not reach as far as the one-way valve.
VENOUS SAMPLING LINE: remove the protective cap from the
luer connector placed beside the venous inlet (fig. 2, ref. 6).
Connect the male luer of the venous sampling line of the ramp.
7) CONNECT THE TEMPERATURE PROBES
The connection for the arterial temperature probe (fig. 2, ref. 16)
is positioned next to the arterial outlet, while the venous probe
site (fig. 2, ref. 3) is located on the venous return connector of
the reservoir.
SORIN GROUP ITALIA temperature probes have the code 09026.
8) CLOSE THE PURGING/RECIRCULATION LINE
Close the purging/recirculation stopcock (refer to the diagram on
the label).
9) CONNECT THE GAS LINE
Remove the green cap from the gas inlet connector indicated as
"GAS INLET" (fig. 2, ref. 13) and connect the 1/4" gas line.
Ensure that the gas supply is from a suitable air/oxygen mixer
such as the Sechrist, code 09046 (available from SORIN GROUP
ITALIA) or a system with compatible technical features.
A capnograph connector can be found in the centre of "GAS
ESCAPE" (fig. 2, ref. 14) connector.
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.
10)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
compromise the proper function 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.
3) CLOSE VENOUS AND ARTERIAL LINES
Clamp the venous line. Clamp the arterial line some centimetres
away from arterial outlet connector of the oxygenator.
4) CHECK THE HEAT EXCHANGER
Verify again the integrity of the heat exchanger, paying
particular attention to possible water leaks.
5) VENOUS RESERVOIR PRIMING
Secure with ties all aspiration lines connected to the Venous
Reservoir. Fill the Venous Reservoir with sufficient liquid to
ensure the intended haematocrit is obtained, taking into
account:
- the static priming volume of the oxygenator is 250 ml;
- the 3/8" tube capacity is 72 ml/m;
- the 1/2" tube capacity is 127 ml/m.
Clamp the Venous Reservoir outlet.
6) CIRCUIT PRIMING
WARNING
- The pressure level inside the blood compartment of the
oxygenating module shall not exceed 100 KPa (1 bar /
14 psi).
Clamp the venous reservoir outlet and remove the pump
segment from the arterial pump head. Fill the pump segment by
keeping it at the same height as the Venous Reservoir and
slowly opening the clamp occluding it.
By slowly bending downward the tube segment to be filled, the
air in the tube will be routed to the oxygenator. The complete
priming of the oxygenating module is completed by gravity.
Once the COMPACTFLO EVOLUTION is filled, place the pump
segment in the arterial pump.
7) OPEN VENOUS AND ARTERIAL LINES
Remove the clamp from the venous and arterial lines and
increase flow up to 2000 ml/min.
8) OPEN THE PURGING/RECIRCULATION LINE
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 7.5 l/min. Open the purging/recirculation
stopcock for some seconds in order to prime the oxygenator
purging/recirculation line.
9) PURGE 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) PRIME OF THE SAMPLING STOPCOCK
Priming of the A/V sampling stopcock is automatic and is
carried out by suitably positioning the arterial, venous and
central selectors in such a way as to allow the priming liquid to
flow from the arterial outlet to the venous reservoir.
11) CLOSE THE PURGING/RECIRCULATION LINE
After 3-5 minutes in which the flow is maintained at a high rate,
all air will be evacuated and it is possible to close the
purging/recirculation line from the dedicated stopcock.
12) CLOSE 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.
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