Troubleshooting
14-26
20077/021 US XTRA Operator’s Manual
Increased Bleeding 1. Anatomical bleeding.
2. Excess hemodilution.
3. Excess anticoagulant.
4. Disseminating Intravascular
Coagulation (DIC).
Characterized by:
– increased fibrin split
products
– decreased fibrinogen
– red cell fragments on the
blood smear
5. Hyperfibrinolysis.
Characterized by:
– decreased euglobulin
lysis time
– decreased levels of
factors V and VIII
6. Undiagnosed preexisting clotting
abnormality OR history of aspirin
therapy.
7. Infusion of thromboplastic fluids (will
precipitate DIC).
1. Maintain surgical hemostasis.
2. Medical management of patient to
assess the need for replacing clotting
factors.
3. Avoid processing partially filled
centrifuge bowls; use at least one liter
during the Wash cycle. Check
anticoagulant flow rate and for other
sources of anticoagulant introduced
intraoperatively.
4. Medical assessment of the patient to
determine treatment.
Use microaggregate filter on the blood
administration line.
Medical assessment of the patient to
determine treatment.
5. Assess ALL patients prior to surgery for
preexisting clotting problems and be
aware of prior anticoagulant therapy if
intraoperative autologous transfusion is
anticipated.
6. Avoid aspirating thromboplastic fluids
into the system.
Issue Possible Cause Possible Action
Table 14-4 Therapy Concerns Unrelated to the Machine (Continued)
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