Priming And Recirculation Procedure - dideco D901 LiLLiPUT Mode D'emploi

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outlet (ref. I) in order to connect a 1/4" or 3/16" line.
PUMP LINE: the pump segment should be set up between the
venous reservoir outlet connector and the oxygenator venous
inlet connector (ref. F) taking account of the direction of rotation
of the pump.
OXYGENATING MODULE PURGE LINE: remove the protective
cap and connect the male luer end (ref. B) to a female luer filte-
red inlet on the cardiotomy.
OXYGENATING MODULE RECIRCULATION LINE: remove the
protective cap and connect the male luer end (ref. A) to a fema-
le luer placed on the venous return line.
CAUTION
If at the end of the bypass blood recovery is envisaged, set up
an "ON-OFF" manifold (with female and male luer lock con-
nections) between the male luer lock of the oxygenating
module recirculation line and the venous reservoir used.
Open the "ON-OFF" manifold (position "ON").
ARTERIAL SAMPLING LINE: remove the protective cap from the
luer connection placed near the arterial outlet (ref. L). Attach to
it the male luer of an arterial sampling line.
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.
7) SAMPLING MANIFOLD (fig.4)
Versions with SOFT VENOUS RESERVOIR
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. 9)
is in the "OFF" position.
8) CONNECTING THE TEMPERATURE PROBES (fig. 4 and 5)
The connection for the arterial temperature probe (red - ref. 14
and H) is positioned next to the arterial outlet, whilst the venous
probe site (blue - ref. 13 and G) is at the side of the venous inlet.
SORIN GROUP ITALIA temperature probes have code 9026.
9) RECIRCULATION AND PURGE LINES
Check that the white clamp positioned on the recirculation line
between the LILLIPUT arterial outlet and the venous reservoir is
open. Close the blue clamp on the oxygenator purge line.
10) CONNECTING THE GAS LINE
Connect the 1/4" gas line to the connector on the upper cover
labelled "GAS INLET". Ensure that the gas supply is from a sui-
table air/oxygen mixer such as the Bird, code 9374 (available
from SORIN GROUP ITALIA) or a system with compatible tech-
nical features. A capnograph connector can be found in the cen-
tre of the connector marked "GAS ESCAPE".
CAUTION
- The "GAS ESCAPE" system is designed to avoid any possi-
ble risk of blocking the gas outlet; such blockage could
cause the immediate passage of air to the blood compart-
ment.
- 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. Such risk could be due to:
1) collapse of the soft venous reservoir, caused by a reduced
venous return; arterial pump cavitation generates
emboli; LILLIPUT purge not being correctly operating,
allowing air to enter artery via the pump.
2) the air which is delivered via the venous cannulae is not
removed promptly from the venous reservoir and is
aspirated by the arterial pump.
- If there is to be continuous administration of anticoagulant
to the patient, use a female luer lock connector on the soft
reservoir venous return connector.
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) SET THE VOLUME OF THE VENOUS RESERVOIR (fig. 4)
Versions with the SOFT VENOUS RESERVOIR
Set the desired volume using the soft reservoir squeezer (ref. 7).
4) ISOLATE THE SOFT VENOUS RESERVOIR AND OXYGENATING
MODULE
Versions with the SOFT VENOUS RESERVOIR
Clamp the cardiotomy outlet, the venous return, the soft venous
reservoir outlet and the arterial outlet of the oxygenator.
5) CHECKING THE HEAT EXCHANGER
Verify again the integrity of the heat exchanger, with particular
attention to possible water leaks.
6) CARDIOTOMY PRIMING
Secure with ties all aspiration lines connected to the cardiotomy.
Fill the cardiotomy with sufficient liquid to ensure the intended
haematocrit is obtained, taking into account:
- the static priming volume of the oxygenator is 60 ml;
- if it is present, soft venous reservoir capacity varies from
minimum 25 to maximum 90 ml;
- the 3/16" tube capacity is 19 ml/m;
- the 1/4" tube capacity is 32 ml/m.
7) CIRCUIT PRIMING
Remove the clamp at the cardiotomy outlet.
Versions with SOFT VENOUS RESERVOIR
The priming solution flows to the soft venous reservoir.
The air contained inside the soft venous reservoir will automati-
cally be evacuated from the purge line which is placed at the top
of the reservoir by activating the suction pump.
remove the clamp placed on the outlet of the soft venous reser-
voir.
WARNING
- The pressure level inside the soft venous reservoir shall not
exceed 13 KPa (0.13 bar / 1.9 psi).
- The pressure level inside the blood compartment of the
oxygenating module shall not exceed 100 KPa (1 bar / 14
psi).
All versions
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.
8) OPENING OF THE VENOUS AND ARTERIAL LINES
Open the purge line of the oxygenator by means of the blue
clamp in order to purge the air which is contained in the line.
Close the clamp. Remove the venous and arterial line clamps
and increase flow up to 800 ml/min.
9) CLOSING THE OXYGENATOR RECIRCULATION LINE
Close the white clamp placed on the recirculation line.
10) 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.
11) PRIMING OF THE 4-WAY SAMPLING MANIFOLD
Versions with the SOFT VENOUS RESERVOIR
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 microbub-
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