c) wash the collected blood and reinfuse to the patient
- 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 ACTIVE VENOUS DRAINAGE WITH VACUUM
This method may be applied at any time of the extracorporeal circu-
lation, provided that the prescriptions below are respected. Through
use of the kit - code 096834 or equivalent supplied separately - and
a vacuum regulation device, EOS may be used with active venous
drainage with vacuum. This technique constitutes an alternative to
venous drainage by gravity and allows the use of shorter venous
tubes with reduced diameter, as well as smaller-gauged cannulas.
1. Open the kit for active venous drainage with vacuum, operating
in such a way that sterility of the system is not compromised.
2. Connect the end with the blue cap to the vent connector of the
venous reservoir (fig. 2, ref. 18) and the end with the red cap
to the vacuum regulating device. The latter must be connected
to the line vacuum.
3. Close the clamp and the green cap on the line connected to the
reservoir.
4. If necessary to interrupt or suspend this method, remove the
yellow cap and open the clamp on the line.
- It is advisable not to exceed –80 mmHg (10.4kPa / 0.10bar)
negative pressure applied to the reservoir.
- Periodically check functioning of the vacuum regulating
device and the degree of vacuum.
- Suspend vacuum application during the entire circulatory
arrest procedure.
L. 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
Drainage Holder” 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. 3) with the red clamp found in the con-
venience kit provided with the product.
- In case negative pressure applied to the system makes pres-
sure relief valve operate, the collected blood is not suitable
for retransfusion as contaminated.
M. 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, clotting of the fil-
ter etc.), proceed as follows for oxygenator replacement.
Use sterile methods during all replacement procedure.
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 (according to the appro-
priate instructions for use) and remove the pump segment from
the arterial pump.
8) Place a new D905 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).
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 through the 1/4” or 3/8” quick prime connectors locat-
ed on the head of the venous reservoir.
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 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)
5
ENGLISH
WARNING
WARNING
WARNING
CAUTION
CAUTION
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