Terumo Xcoating CAPIOX RX Serie Bedienungsanleitung Seite 28

POST-OPERATIVE CHEST DRAINAGE
Contraindications
Post-Operative chest drainage with subsequent autotransfusion procedures are contraindicated in the following events:
• Gross perforations to the chest wall or an air leak in the lungs.
• Infection or malignancy occurring systemically or in the pericardium, mediastinum, or lungs.
• Suspected or evident gross contamination with foreign material, lymphatic failure, or perforated intestine.
• Presence of the following in the aspiration site: topical hemostatic agents, bactericidal wound irrigants or antibiotics not
intended for parenteral administration.
• Open chest and vacuum applied.
• Administration of protamine prior to reservoir removal from bypass circuit.
• Patient returned to surgery for any reason.
• Use of vented chest tubes that do not have vent flow regulation such as stopcocks.
Warnings
• A qualified person should assess the quality and suitability of returning any blood that has been collected before reinfusion begins.
The safe reinfusion of collected fluids is the sole responsibility of the attending physician.
• Complications such as the following have been associated with chest drainage and subsequent reinfusion: blood trauma, blood
coagulation, coagulopathies, and particulate or air embolism.
• Reinfusion of collected blood/fluid should be done on an hourly basis unless fewer than 50 mL are collected hourly.
• A minimum reservoir level of 20 mL of fluid should always be maintained to prevent air embolus passing to patient.
• Blood that has been in the reservoir for longer than 4 hours should not be transfused.
• It is not recommended that autotransfusion continue longer than 18 hours after surgery.
• Attach a shunt line (the bridge) to connect the filtered and unfiltered sections in the reservoir as indicated in instructions for use.
• When using the reservoir, monitor the attached shunt line for blood in the line. If blood is detected in the line this is an indication
that the reservoir filter has clotted. Replace reservoir promptly.
• Filter occlusion during high volume chest drainage may cause blood/fluid to pass through the external shunt line bypassing filtration.
All fluids that pass through the shunt line must be filtered prior to reinfusion.
• Accepted medical and nursing care routines must be followed during chest drainage.
• When vacuum is used during chest drainage, do not exceed -20 kPa (-150 mmHg) (-204 cmH
Hardshell Reservoir Operating Specifications for Post-Operative Chest Drainage
ITEM
Cardiotomy Maximum Blood Flow Range
Blood Storage Capacity
Minimum level in reservoir
List of Required Materials for Use of Reservoir for Post-Operative Chest Drainage
REFERENCE QUANTITY
[a] 6 each 1/4" (6.4 mm) I.D. dead-end tubing with cap
[b] 1 each 3/8" (9.5 mm) I.D. tubing with caps
1/2" (12.7 mm) X 1/2" (12.7 mm) connector with 1/2" (12.7 mm) I.D. dead-end tubing with
cap for RX25/RX15R40. 3/8" (9.5 mm) x 3/8" (9.5 mm) connector with 3/8" (9.5 mm) I.D.
[c] 1 each dead-end tubing with cap for RX15R30
3/8" (9.5 mm) X 3/8" (9.5 mm) X 3/8" (9.5 mm) Y connector with 3/8" (9.5 mm) I.D.
[d] 2 each 40 Durometer tubing with caps
[e] 1 each 3/8" (9.5 mm) I.D. dead-end tubing with cap
3/8" (9.5 mm) perfusion adapter attached to 4" (101.6 mm) of
1/8" (3.175 mm) I.D. tubing that includes a clamp with female luer end,
connected to male luer with 48" (1219.2 mm) of 1/8" (3.175 mm) I.D. tubing
with another female luer end connected to a male luer with
[f] 1 each 2.5" (63.5 mm) of 3/16" (4.8 mm) I.D. tubing end is covered by a cap
Vacuum relief valve: Opening vacuum range: 30-60 cmH
[g]
1 each
(2.9-5.9 kPa) with bacterial filter
[h] 1 each 1/4" (6.4 mm) I.D. tubing
[i] 1 each Water manometer
[j] 1 each 1/4" (6.4 mm) I.D. tubing
[k] 1 each Male non-vented luer lock cap
[l] 1 each Three way stopcock capable of opening three way simultaneously
Instructions for Use
NOTE: When referring to the instructions for Post Operative Chest Drainage, the bracketed letters refer to the List of Required
Materials on page 12 and the parenthesized numbers refer to the illustration on page 3.
1. Carefully remove tubing and/or blue caps from suction inlet ports (6) of reservoir. Plug five of the suction inlet ports with
1/4" (6.4 mm) I.D. dead-end tubes [a].
2. Attach 3/8" (9.5 mm) I.D. tubing [b] from the auxiliary port (2) to one of the suction inlet ports (6); all suction inlet ports are
1/4"(6.4 mm) - 3/8" (9.5 mm). This will create a bridge between the filtered and unfiltered sections of the reservoir.
1
Standards for Blood Banks and Transfusion Services, 16th ed. American Association of Blood Banks
2
Page. R, et al, Hard-Shell Cardiotomy Reservoir for Reinfusion of Shed Mediastinal Blood. Ann Thorac Surg 1989:48:514-7.
12
1
2
SPECIFICATION
RX25 RX15R40
5 L/min 5 L/min
4000 mL 4000 mL
20 mL 20 mL
DESCRIPTION
0 (22-44 mmHg)
2
O).
2
RX15R30
4 L/min
3000 mL
20 mL
TUBING LENGTH
2" (50.8 mm) each
12" (304.8 mm)
6" (152.4 mm)
96" (2438.4 mm)
4" (101.6 mm)
N/A
N/A
As needed
N/A
18" (457.2 mm)
N/A
N/A