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Ensure that the arterial stopcock is closed,
and so not communicating with the venous
line. Insert a sampling syringe into the venous
stopcock luer and draw at least 10 ml of blood
prior to take the venous sample.Turn the venous
sampling stopcock and proceed to the venous
sampling with another syringe. Return the
collected venous blood in the central stopcock
luer. Return the blood residual from gas analysis
in the central stopcock luer. Ensure to turn all
stopcock to allow the blood re-circulation at the
end of the operation.
4) DRUGS INJECTION
Insert the medication syringe into the luer port
of the central stopcock. Open the central and
venous stopcocks and inject the drug into the
manifold and venous sample line.
Close the central stopcock to the medication
syringe and allow drug wash through the
stopcock manifold from arterial to venous blood.
Turn the stopcocks to the closed position when
the drug has been delivered to the venous line.
5) LOW FLOW RECIRCULATION
(Hypothermia associated with circulatory arrest)
WARNINGS
If performing vacuum-assisted drainage, please
adhere strictly to the following:
a) reduce the gas flow rate to less than 500 ml/
min,
b) open the purge line of the arterial filter or the
arterial-venous loop,
c) reduce the flow rate of the arterial pump to
1000 ml/min and clamp the venous reservoir
inlet line,
d) clamp the oxygenator arterial line after
the recirculation loop and recirculate
at a maximum flow rate of 1000 ml/min
throughout the patient's circulatory arrest,
e) to restart bypass after circulatory arrest,
open the venous and arterial lines and slowly
increase the blood flow,
f) close the recirculation line used and adjust
the gas flow.
Resume the arterial pump flow to the value
previously setted.
In case of vacuum-assisted drainage, increase
the negative pressure in cardiotomy/reservoir, to
reach an adequate drainage flow.
If you need to add priming solution to the venous
reservoir, use the 1/4" ports, the luer locks
or the POS locks located on the turret of the
cardiotomy/venous reservoir.
Perform sampling only when the pump is
running, otherwise the blood pressure in the
compartment would drop and might lead to the
formation of air bubbles.
WARNING
For the low flow recirculation, do not use
the purge line, because it doesn't allow the
recirculation of oxygenator module.
6) CONTINUOUS AIR PURGING
If air continuously arrives at the oxygenator, hold
the clamp of the purge line partially open so as to
eliminate the air (this procedure however entails
a drop in flow rate to the patient, proportional to
the clamp opening, the arterial pump flow rate
and the arterial pressure).
TERMINATING BYPASS
This must be carried out depending on the condition
of each individual patient. Act as follows:
1) Turn off the gas flow.
2) Turn the heater-cooler off.
3) Slowly reduce the arterial flow to zero, at the
same time closing the venous line.
4) Clamp the arterial line.
5) Open the arterial / venous recirculation line or
the purge line.
6) Increase the arterial flow rate to 1000 ml/min.
CAUTION
If extracorporeal circulation has to be restarted,
maintain a minimum blood flow inside TRILLY
PAEDIATRIC AF (maximum 1000 ml/min).
Check that the cardioplegia circuit connected to the
coronary outlet is properly clamped.
CAUTION
We recommend that you disconnect the venous
reservoir from the oxygenator module when the
same is still on the holder (press the release button
and rotate counterclockwise the blue ring, indicated
by the lock open).
RECOVERING THE BLOOD VOLUME AFTER
BYPASS
1) Recover all the blood contained in the venous line
into the cardiotomy/venous reservoir as soon as
the surgeon has removed the cannula from the
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