Priming And Recirculation Procedure - dideco D 905 EOS Instrucciones De Uso

plate in the "D 712 Holder for Sampling Manifold".
The tube coil attached to the manifold allows it to be reposi-
tioned to a range of approximately 1 metre.
Verify the connection of the manifold purge line with the "fil-
tered" luer lock of the Venous Reservoir. Check that the selector
switch is in the "OFF" position.
7) CONNECT THE TEMPERATURE PROBES
The connection for the arterial temperature probe (red – fig. 2,
ref. 11) is positioned next to the arterial outlet, while the venous
probe site (blue – fig. 2, ref. 12) is at the side of the venous inlet.
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 transmis-
sion to the patient.
10) VAPOROUS ANAESTHESTICS
The oxygenator is suitable for use with volatile anaesthetic isoflu-
rane and sevoflurane, by mean of a suitable narcosis gas evapo-
rator. If these vaporous anaesthetics are used, some method of
scavenging the gas from the oxygenator should be considered.
The protocol, the concentration and the monitoring of the anaes-
thetic 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 isofluorane
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 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 particu-
lar 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 160 ml;
- the 3/8" tube capacity is 72 ml/m;
- the 1/2" tube capacity is 127 ml/m.
Clamp the Venous Reservoir outlet.
In order to fill the Venous Reservoir or if the Cardiotomy
Reservoir capacity (1200 mls) is not enough, open the connec-
tion to the Venous Reservoir by raising the connection key (fig.
2, ref.5) 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).
Clamp the venous reservoir outlet and remove the pump seg-
ment from the arterial pump head. Fill the pump segment by
keeping it at the same height as the Venous Reservoir and slow-
ly 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 mod-
ule is completed by gravity.
Once the D 905 EOS 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 5 l/min. Open the purging/recirculation stop-
cock for some seconds in order to prime the oxygenator purg-
ing/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 MANIFOLD
The removal of the air from the A/V sampling system and from
the coronary outlet port is achieved as follows:
- Rotate the manifold selector switch in the "A-V SHUNT" posi-
tion.
- Check that the A/V sampling line is completely purged.
- Reset the manifold selector switch in the OFF position.
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.
- 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.
WARNING
- If the reduction connector (D523C) and a circuit have been
connected to the coronary outlet port, check the priming of
the connected line.
- Clamp the line some centimetres away from the outlet.
- Do not create a negative pressure at the coronary outlet.
Negative pressure in the blood compartment could cause
microbubble formation.
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