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Maquet CS100i - User Manual

Maquet CS100i
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Summary

Recommended IABP Triggers

ECG-Based Triggers

Includes ECG Pattern (QRS analysis) and ECG Peak (wide complex). Analyzes QRS complex height, width, slope.

Pacer-Based Triggers

For 100% paced rhythms. Uses ventricular (V Pace) or atrial (A Pace) spikes as trigger signals.

Other Trigger Sources

Includes Arterial Pressure (systolic upstroke), Internal (no cardiac cycle), and CPR synchronization.

Balloon Pressure Waveform Analysis

Waveform Description

Represents helium movement, allows objective assessment of counterpulsation.

BPW Height Analysis

Reflects aortic pressure. Plateau pressure should be ±20mmHg of PDP.

BPW Width Analysis

Duration in which the balloon is inflated.

Waveform Troubleshooting

Reduced & Poor Augmentation

Examines issues like purge failure, low helium, low plateau pressure.

Baseline Issues

Addresses baseline below zero, elevated baseline, and high baseline.

Plateau Pressure & Artifacts

Covers squared/rounded plateau pressure and inflation/deflation artifacts.

High Pressure Conditions

Identifies causes of high pressure like kinked catheter or balloon size.

Timing Guidelines

Inflation Timing Goal

Goal is rapid aortic rise, optimize PDP, increase O2 supply. Inflate prior to DN.

Deflation Timing Goal

Goal is to reduce afterload, improve CO. BAEDP < PAEDP.

Assisted Waveform Definitions

Defines key terms like PAEDP, PSP, PDP, BAEDP, APSP, DN for waveform analysis.

Incorrect Timing States

Early Inflation Timing

IAB inflated before DN. Violates Rule 1 for inflation. Reduces SV/CO.

Late Inflation Timing

DN visible between PSP and PDP. Violates Rule 1 for inflation. Less than optimum PDP.

Early Deflation Timing

APSP = PSP. Violates Rule 1 for deflation. No afterload reduction.

Late Deflation Timing

BAEDP > PAEDP. Violates Rule 2 for deflation. Increased LV workload, MVO2.

CS100 Bezel and Keypad Overview

Quick Reference - Initial Set-up

Operating Modes

AUTO Operation Mode

All aspects automated: trigger, inflation/deflation timing, lead selection.

SEMI AUTO Operation Mode

Operator selects trigger source; timing adjusted automatically. Standby on trigger change.

Manual Operation Mode

Operator determines trigger source and timing. Standby on trigger change.

Trigger Source Selection

ECG Trigger

R wave is trigger event. Pacer spikes rejected. ESIS is automatic.

Pressure Trigger

Systolic upstroke of arterial waveform is trigger. Threshold adapts to pulse height.

Pacer V;A-V Trigger

Uses ventricular/atrial spike for 100% paced rhythms. For unsuccessful ECG triggering.

Advanced Trigger Sources

Pacer A Trigger

R-wave ECG trigger with enhanced atrial pacer spikes. For atrial pacer tail interference.

Internal Trigger

For no mechanical cardiac cycle (bypass, asystole). Fixed at 80 BPM, adjustable 40-120 BPM.

Timing Adjustments

Setting Initial Inflation Timing

Use IAB Inflation arrows until highlighted segment begins at dicrotic notch.

Setting Initial Deflation Timing

Use IAB Deflation arrows to adjust end of highlighted segment before ventricular ejection.

Maximizing Assist

Semi-Auto/Manual modes allow IAB inflation/deflation control for optimal assist.

Clinical Troubleshooting

ECG Acquisition Issues

Correct unreliable ECG by repositioning electrodes or changing gain/lead.

Pressure Monitoring Issues

Maintain line patency with flushing to prevent pressure trace problems.

Atrial Fibrillation Handling

Use ECG Trigger in SEMI AUTO. Pressure trigger not recommended.

Triggering on Ectopic Beats

System assists ectopic beat if R-wave sensed. Select ECG lead to minimize amplitude difference.

Special Patient Conditions & Troubleshooting

CPR Synchronization

Use ECG or Arterial Pressure trigger during CPR for synchronization.

Prolonged Standby Operation

Alerts for >10 min standby. Warning against >30 min inactivity due to thrombus risk.

Changing Pressure Monitoring Site

Press INFLATION INTERVAL to recalculate APD after changing monitoring site.

System Alarms and Advisories

Trigger Alarms

Indicates trigger source unavailable or unreliable. Pumping suspended until trigger reestablished.

Operator Intervention: No Trigger

Reattach electrodes, switch to SEMI AUTO, adjust gain, or select new trigger source.

Operator Intervention: Poor Signal

Flush circuit, check connections, improve ECG signal, or switch to SEMI AUTO.

SEMI AUTO;Manual Trigger Alarms

No Trigger (SEMI;Manual)

Valid trigger lost in ECG or Pacer mode. Operator intervention: reattach, select new source.

No Pressure Trigger

Valid trigger unavailable in pressure mode. Verify source, transducer, or select new trigger.

Check Pacer Timing

Patient not 100% paced or A-V interval/rate issues. Select ECG trigger or adjust timing.

Trigger Interference

ESU detected with Pacer trigger. Pumping resumes when interference clears.

Catheter Alarms

IAB Circuit Leaks & Gas Loss

Small leak or high helium diffusion. Check connections and tubing.

IAB Disconnected

IAB catheter or extender tubing disconnected. Reconnect or inspect.

IAB Catheter Issues

IAB membrane not unfolded, kinked, or in sheath. Inspect catheter and tubing.

Blood Detected in Catheter

Blood detected in IAB catheter. Stop pumping and notify physician.

Autofill Failure

Helium tank empty/closed or IABP cannot fill. Check tank or system.

System Alerts

AUTO Mode Alerts

Covers poor signal quality, no pressure source, and inability to update timing.

SEMI;Manual Mode Alerts

Includes ECG detected during internal trigger and irregular pressure trigger.

General Alerts (ALL Modes)

Includes augmentation below limit set and low battery alerts.

Status;Prompts Messages

Manual Fill Related Prompts

Prompts for IAB not filled or manual fill notification.

Trigger Source Prompts

Indicates trigger source has changed and requires timing verification.

System Operation Prompts

Messages regarding autofilling, AUTO mode disable, and gas loss alarms.

R-Wave Deflation Prompts

Indicates system selected R-Wave Deflation due to random rhythm.

Menu Navigation and Guide

Menu Navigation Basics

How to open menus and navigate selections using arrow keys.

ECG;AP Sources Menu

Allows selection of ECG Lead Source and Pressure Source.

Pump Options Menu

Provides access to adjust ECG Gain, Pressure Threshold, Internal Rate, etc.

User Preferences Menu

Configures display, alarms, audio, and print settings.

Safety Disk Leak Test

Transport Considerations

Portable Operation Guidelines

Recommendations for battery, security, altitude compensation during transport.

UTS Transport System

Console version with hospital cart or UTS for air/vehicular transport.

Transport Safety Precautions

Use visual alarms, check helium levels, verify yoke tightness during transport.

Battery Operation and Charging

Battery Status Indicators

Low battery alerts (audible, visual), battery indicator flashing, module inactive.

Battery Charging Procedure

Charge via AC power. Allow 18 hours for full charge. New battery ~135 min runtime.

Power Source Switching and Altitude Effects

AC to Battery Power Transition

System switches to battery if AC power is lost. Reverts to AC when restored.

DC-to-AC Inverter Operation

System can use inverter power; check specifications and qualified personnel.

Air Transport Altitude Compensation

Auto Fill compensates for pressure changes. Manual fill needed if Auto Fill unavailable.

Removing Pump Console from Cart

Console Removal with Battery Pack

Unlock console, lift straight up. Ensure cart wheels are locked.

Detaching the Battery Pack

Lift battery release levers, unlock tab, lift battery. Lower console onto battery pack.

Attaching Monitor to Pump Console

Summary

Recommended IABP Triggers

ECG-Based Triggers

Includes ECG Pattern (QRS analysis) and ECG Peak (wide complex). Analyzes QRS complex height, width, slope.

Pacer-Based Triggers

For 100% paced rhythms. Uses ventricular (V Pace) or atrial (A Pace) spikes as trigger signals.

Other Trigger Sources

Includes Arterial Pressure (systolic upstroke), Internal (no cardiac cycle), and CPR synchronization.

Balloon Pressure Waveform Analysis

Waveform Description

Represents helium movement, allows objective assessment of counterpulsation.

BPW Height Analysis

Reflects aortic pressure. Plateau pressure should be ±20mmHg of PDP.

BPW Width Analysis

Duration in which the balloon is inflated.

Waveform Troubleshooting

Reduced & Poor Augmentation

Examines issues like purge failure, low helium, low plateau pressure.

Baseline Issues

Addresses baseline below zero, elevated baseline, and high baseline.

Plateau Pressure & Artifacts

Covers squared/rounded plateau pressure and inflation/deflation artifacts.

High Pressure Conditions

Identifies causes of high pressure like kinked catheter or balloon size.

Timing Guidelines

Inflation Timing Goal

Goal is rapid aortic rise, optimize PDP, increase O2 supply. Inflate prior to DN.

Deflation Timing Goal

Goal is to reduce afterload, improve CO. BAEDP < PAEDP.

Assisted Waveform Definitions

Defines key terms like PAEDP, PSP, PDP, BAEDP, APSP, DN for waveform analysis.

Incorrect Timing States

Early Inflation Timing

IAB inflated before DN. Violates Rule 1 for inflation. Reduces SV/CO.

Late Inflation Timing

DN visible between PSP and PDP. Violates Rule 1 for inflation. Less than optimum PDP.

Early Deflation Timing

APSP = PSP. Violates Rule 1 for deflation. No afterload reduction.

Late Deflation Timing

BAEDP > PAEDP. Violates Rule 2 for deflation. Increased LV workload, MVO2.

CS100 Bezel and Keypad Overview

Quick Reference - Initial Set-up

Operating Modes

AUTO Operation Mode

All aspects automated: trigger, inflation/deflation timing, lead selection.

SEMI AUTO Operation Mode

Operator selects trigger source; timing adjusted automatically. Standby on trigger change.

Manual Operation Mode

Operator determines trigger source and timing. Standby on trigger change.

Trigger Source Selection

ECG Trigger

R wave is trigger event. Pacer spikes rejected. ESIS is automatic.

Pressure Trigger

Systolic upstroke of arterial waveform is trigger. Threshold adapts to pulse height.

Pacer V;A-V Trigger

Uses ventricular/atrial spike for 100% paced rhythms. For unsuccessful ECG triggering.

Advanced Trigger Sources

Pacer A Trigger

R-wave ECG trigger with enhanced atrial pacer spikes. For atrial pacer tail interference.

Internal Trigger

For no mechanical cardiac cycle (bypass, asystole). Fixed at 80 BPM, adjustable 40-120 BPM.

Timing Adjustments

Setting Initial Inflation Timing

Use IAB Inflation arrows until highlighted segment begins at dicrotic notch.

Setting Initial Deflation Timing

Use IAB Deflation arrows to adjust end of highlighted segment before ventricular ejection.

Maximizing Assist

Semi-Auto/Manual modes allow IAB inflation/deflation control for optimal assist.

Clinical Troubleshooting

ECG Acquisition Issues

Correct unreliable ECG by repositioning electrodes or changing gain/lead.

Pressure Monitoring Issues

Maintain line patency with flushing to prevent pressure trace problems.

Atrial Fibrillation Handling

Use ECG Trigger in SEMI AUTO. Pressure trigger not recommended.

Triggering on Ectopic Beats

System assists ectopic beat if R-wave sensed. Select ECG lead to minimize amplitude difference.

Special Patient Conditions & Troubleshooting

CPR Synchronization

Use ECG or Arterial Pressure trigger during CPR for synchronization.

Prolonged Standby Operation

Alerts for >10 min standby. Warning against >30 min inactivity due to thrombus risk.

Changing Pressure Monitoring Site

Press INFLATION INTERVAL to recalculate APD after changing monitoring site.

System Alarms and Advisories

Trigger Alarms

Indicates trigger source unavailable or unreliable. Pumping suspended until trigger reestablished.

Operator Intervention: No Trigger

Reattach electrodes, switch to SEMI AUTO, adjust gain, or select new trigger source.

Operator Intervention: Poor Signal

Flush circuit, check connections, improve ECG signal, or switch to SEMI AUTO.

SEMI AUTO;Manual Trigger Alarms

No Trigger (SEMI;Manual)

Valid trigger lost in ECG or Pacer mode. Operator intervention: reattach, select new source.

No Pressure Trigger

Valid trigger unavailable in pressure mode. Verify source, transducer, or select new trigger.

Check Pacer Timing

Patient not 100% paced or A-V interval/rate issues. Select ECG trigger or adjust timing.

Trigger Interference

ESU detected with Pacer trigger. Pumping resumes when interference clears.

Catheter Alarms

IAB Circuit Leaks & Gas Loss

Small leak or high helium diffusion. Check connections and tubing.

IAB Disconnected

IAB catheter or extender tubing disconnected. Reconnect or inspect.

IAB Catheter Issues

IAB membrane not unfolded, kinked, or in sheath. Inspect catheter and tubing.

Blood Detected in Catheter

Blood detected in IAB catheter. Stop pumping and notify physician.

Autofill Failure

Helium tank empty/closed or IABP cannot fill. Check tank or system.

System Alerts

AUTO Mode Alerts

Covers poor signal quality, no pressure source, and inability to update timing.

SEMI;Manual Mode Alerts

Includes ECG detected during internal trigger and irregular pressure trigger.

General Alerts (ALL Modes)

Includes augmentation below limit set and low battery alerts.

Status;Prompts Messages

Manual Fill Related Prompts

Prompts for IAB not filled or manual fill notification.

Trigger Source Prompts

Indicates trigger source has changed and requires timing verification.

System Operation Prompts

Messages regarding autofilling, AUTO mode disable, and gas loss alarms.

R-Wave Deflation Prompts

Indicates system selected R-Wave Deflation due to random rhythm.

Menu Navigation and Guide

Menu Navigation Basics

How to open menus and navigate selections using arrow keys.

ECG;AP Sources Menu

Allows selection of ECG Lead Source and Pressure Source.

Pump Options Menu

Provides access to adjust ECG Gain, Pressure Threshold, Internal Rate, etc.

User Preferences Menu

Configures display, alarms, audio, and print settings.

Safety Disk Leak Test

Transport Considerations

Portable Operation Guidelines

Recommendations for battery, security, altitude compensation during transport.

UTS Transport System

Console version with hospital cart or UTS for air/vehicular transport.

Transport Safety Precautions

Use visual alarms, check helium levels, verify yoke tightness during transport.

Battery Operation and Charging

Battery Status Indicators

Low battery alerts (audible, visual), battery indicator flashing, module inactive.

Battery Charging Procedure

Charge via AC power. Allow 18 hours for full charge. New battery ~135 min runtime.

Power Source Switching and Altitude Effects

AC to Battery Power Transition

System switches to battery if AC power is lost. Reverts to AC when restored.

DC-to-AC Inverter Operation

System can use inverter power; check specifications and qualified personnel.

Air Transport Altitude Compensation

Auto Fill compensates for pressure changes. Manual fill needed if Auto Fill unavailable.

Removing Pump Console from Cart

Console Removal with Battery Pack

Unlock console, lift straight up. Ensure cart wheels are locked.

Detaching the Battery Pack

Lift battery release levers, unlock tab, lift battery. Lower console onto battery pack.

Attaching Monitor to Pump Console

Maquet CS100i Specifications

General IconGeneral
TypeSurgical Table
ManufacturerMaquet
ModelCS100i
Table Width500 mm (19.7 in)
Lateral Tilt+/- 20°
Power Supply100-240 VAC, 50/60 Hz

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