Medtronic Affinity Pixie Gebrauchsanweisung Seite 26

10. Remove the obturator cap from the CVR positive/negative pressure relief valve.
11. Connect all blood, gas, and suction lines to their appropriate connections per institution CPB protocol. If
necessary, attach an appropriately sized adapter to the blood inlet or outlet port to accommodate 0.5 cm
(3/16 in) or 1.0 cm (3/8 in) tubing.
12. The sampling manifold should be attached so that the tubing segment with the one-way duckbill valve is
positioned between the oxygenator arterial sample port and manifold and that arterial blood flows through
the duckbill valve toward the manifold.
13. Connect the recirculation line to the recirculation port on the oxygenator. Connect the other end of the
recirculation line to a luer port on the CVR.
Warning: If not used, the recirculation port should be sealed tightly with a luer cap.
14. Connect quick-connect 1.2 cm (1/2 in) water lines to inlet and outlet ports on the oxygenator. Start the water
flow and check for leaks from the water compartment to the blood compartment. Discard oxygenator if water
is present in the blood compartment and set up the standby oxygenator.
15. Ensure that the CVR is vented to atmosphere by removing the vent port cap.
Note: A CO flush of the oxygenator is recommended before priming.
2
10.2. Priming and recirculation
1. Fill the CVR with the appropriate volume of priming solution per institution CPB protocol.
2. Remove all bubbles in the section of tubing (roller pump head/boot) or centrifugal pump (if used) from the
CVR outlet to the oxygenator inlet.
3. Gravity prime the oxygenator or prime by forward pump flow per institution CPB protocol.
4. Gradually begin recirculation flow using a prebypass filter per institution CPB protocol.
5. Ensure that the oxygenator is free of bubbles.
6. Add additional priming solution, if needed, to prime the rest of the extracorporeal circuit.
7. Upon completion of priming and debubbling, gradually reduce blood flow and stop pump, close all purge
lines, and clamp arterial, venous, and recirculation lines.
8. Ensure that the entire extracorporeal circuit is free of bubbles before initiating bypass.
Note: Priming solution may be prewarmed through heat exchanger before initiating bypass.
10.3. Initiation of bypass
Warning: The blood phase pressure should be greater than the gas phase pressure at all times.
1. Ensure that the gas outlet port is not obstructed.
2. Check for adequate levels of anticoagulation before initiating bypass.
3. Remove arterial and venous clamps and gradually increase blood flow. Then initiate gas flow with
appropriate gas settings per institution CPB protocol and clinical judgment specific to the patient and
procedure.
4. Adjust water temperature to meet clinical demands.
10.4. Operation during bypass
1. Arterial PO is controlled by varying the percent concentration of oxygen present in the ventilating gas.
2
■
To decrease the PO
your gas blender.
■
To increase the PO
your gas blender.
2. PCO is controlled primarily by varying the total gas flow rate.
2
■
To decrease PCO
■
To increase PCO
3. Patient temperature is controlled by regulating the temperature of the water flow in the heat exchanger.
Warning: After initiation of bypass, blood flow should circulate through oxygenator and CVR at all times
within blood flow range during CPB, except during emergency oxygenator replacement.
Note: Care should be taken to minimize temperature gradient during cooling and warming phases of
bypass.
10.5. Termination of bypass
Terminate bypass per institution CPB protocol as individual case and patient condition indicates.
10.6. Emergency oxygenator replacement
A standby oxygenator and CVR should always be available during CPB.
1. Turn off water flow to the heat exchanger, then clamp and remove the water lines.
24 Instructions for Use
, decrease the percent of oxygen in the ventilating gas by adjusting the FiO
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, increase the percent of oxygen in the ventilating gas by adjusting the FiO
2
, increase the total gas flow rate to increase the amount of CO
2
, decrease the total gas flow rate to decrease the amount of CO
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