Blood Recovery After Bypass; Oxygenator Replacement - dideco D 905 EOS Instrucciones De Uso

2) Turn the thermocirculator off.
3) Slowly decrease the arterial flow to zero while closing the
venous line.
4) Clamp the arterial line.
5) Open the recirculation line.
6) Increase arterial flow until 2000 ml/min.
7) In the case of separation of blood recovered by the aspirators:
a) remove the pos-lock on the connection key (fig. 2, ref. 5) and
connect the adapter D 523C (provided with the product)
b) recover the blood collected in the Cardiotomy Reservoir with
an autotransfusion machine connected to the adapter with a
1/4" line
c) wash the collected blood and reinfuse to the patient
WARNING
- If extracorporeal circulation has to be subsequently restarted,
a minimum blood flow inside the D 905 EOS must be main-
tained (maximum 2000 ml/min).
- During recirculation do not turn the thermocirculator off.
- Verify that the cardioplegia circuit connected to the coronary
outlet port is properly clamped.
J. BLOOD RECOVERY AFTER BYPASS
1) Recover into the Venous Reservoir as much blood as possible
from the venous line, as soon as the surgeon has removed the
cannulae from the patient's vena cava.
2) Deliver blood into the aortic canulae as required by the patient's
condition, slowly decreasing the level in the Venous Reservoir.
3) When the reservoir is nearly empty stop the arterial pump and
clamp the arterial line.
K. USE OF CARDIOTOMY RESERVOIR FOR POST-OPERA-
TIVE AUTOTRANSFUSION
If the use of the Cardiotomy Reservoir for post-operative autotrans-
fusion is envisaged, act as follows:
1. Disconnect the purging/recirculation line.
2. Separate the venous reservoir from the oxygenating module by
removing the white hook.
3. Locate the venous reservoir on the "Post Operative Chest
DrainageHolder code 05039" and use one of the following
optional kits referring to their respective instructions for use:
- D 540 AUTOTRANSFUSION CONVERSION KIT code 05053;
- D 540 W AUTOTRANSFUSION CONVERSION KIT with water
seal, code 05062.
4. If wishing to use the full capacity of the reservoir, lock the con-
nection key (fig. 2, ref. 5) with the red clamp found in the con-
venience kit provided with the product.
L. OXYGENATOR REPLACEMENT
A spare oxygenator must always be available during perfusion. After
6 hours of use with blood or if particular situations occur, which
may lead the person responsible for perfusion to determine that the
safety of the patient may be compromised, (insufficient oxygenator
performance, leaks, abnormal blood parameters etc.), proceed as
follows for oxygenator replacement.
CAUTION
Use sterile methods during all replacement procedure.
Replacement of the oxygenator and the EOS DUALRESERVOIR
1) Turn the gas flow off.
2) Close, by means of a double clamp, the venous line (5 centime-
tres apart).
3) Turn the arterial pump off and close, by means of a double
clamp, the arterial line (5 centimetres apart) placed next to the
oxygenator.
4) Turn the thermocirculator off, clamp and remove the water lines.
5) Disconnect the gas line, all monitoring and sampling lines.
6) Cut the venous return and the arterial lines in the section
between the two clamps, leaving a sufficient length of tubing to
allow re-connection.
7) Remove the D 905 EOS from the holder and remove the pump
segment from the arterial pump.
8) Place a new D 905 EOS on the holder. Connect all lines (i.e.
venous to the Venous Reservoir, arterial and gas to the oxy-
genator, pump line to Venous Reservoir and oxygenator).
WARNING
In this phase, keep the venous and arterial lines clamped.
9) Open the water lines on the holder, turn the thermocirculator on
and check the integrity of the new D 905 EOS.
10) Fill the cardiotomy reservoir of the new D 905 EOS with priming
solution.
11) Prime the new D 905 EOS and evacuate the microbubbles, as
described in the priming and recirculation procedure.
12) Verify all connections and secure with ties.
13) Remove clamps from the venous and the arterial line, close the
purging/recirculation line and start the bypass again.
14) The blood remaining in the replaced Venous Reservoir may be
recovered by connecting its outlet port to one of the 3/8" inlet
connectors of the new reservoir.
15) The blood contained in the oxygenator and heat exchanger may
be poured into the new Venous Reservoir by connecting the
arterial line to one of the 3/8" inlet connectors of the new reser-
voir.
Replacement of only the oxygenating module
1) Turn the gas flow off and disconnect the gas line.
2) Clamp the venous return.
3) Turn the arterial pump off and close, by means of a double
clamp, the arterial line (5 centimetres apart) next to the oxy-
genator.
4) Close, by means of a double clamp, the oxygenator inlet line
near the oxygenating module connector (5 centimetres apart).
5) Turn the thermocirculator off, clamp and remove the water lines.
6) Close the purging/recirculation stopcock and disconnect the
purging/recirculation line.
7) Clamp and disconnect the cardioplegia line, if connected.
8) Turn the sampling manifold selector switch to the "OFF" posi-
tion.
9) Disconnect the arterial sampling avoiding any contamination of
the sampling stopcock luer lock (i.e. by connecting it to a female
luer lock placed on the top of the reservoir).
10) Remove all other monitoring and sampling lines from the oxy-
genating module.
11) Cut the oxygenator inlet line and the arterial line in the section
between the two clamps, leaving a sufficient length of tubing to
allow re-connection.
12) Move the water locking system to the "OPEN" position.
13) Lift the oxygenator and rotate the hook (fig. 1, ref. 2) on the
upper part of the holder.
14) Fit the slot of the reservoir into the hook of the holder.
15) Uncouple the reservoir from the oxygenating module by means
of the white interface (fig. 2, ref.19)
16) Remove the oxygenating module from the holder.
17) Place a new D 905 EOS oxygenating module on the holder.
18) Fix it by moving the water connector locking system to the
"CLOSE" position.
19) Connect the oxygenator inlet line and the arterial line to the oxy-
genating module
WARNING
In this phase, keep the venous and arterial lines clamped.
20) Switch on the thermocirculator and check the heat exchanger.
21) Lift the reservoir and rotate the hook. Put the reservoir on the
oxygenating module. If possible couple the reservoir and the
oxygenating module by means of the white interface.
22) Connect the gas line, the arterial sampling line and all the mon-
itoring lines.
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