SORIN GROUP VVR 4000i Instrucciones De Uso página 5

PROCEDURES FOR USE FOR CARDIOPULMONARY
BYPASS
SETUP PROCEDURES
1. Place the venous reservoir in the bracket.
Ensure that the mounting bracket (catalog no. 050305400) is
securely fastened to the pump console and oriented to pro-
vide maximum visibility during use. The bracket can be
placed on either side of the pump.
Remove the venous reservoir from the shipping carton and
inspect the sterile wrapper for damage. Do not use if sterility
has been compromised. Record the serial number located on
the back underside of the reservoir.
Install the venous reservoir in the mounting bracket and
ensure that the reservoir is stable. (Refer to the instructions
for use for the mounting bracket for a description of the
bracket mounting and assembly).
For better orientation of the ports on the top of the venous
reservoir, the cover can be rotated to the desired orientation.
2. Blood Temperature Monitoring
If desired, insert a Sorin Group Italia reusable (nonsterile)
temperature probe (catalog no. 042229000) into the venous
temperature probe fitting. Lock the temperature probe into
place by twisting the connector sleeve clockwise into the
locked position. Attach probe jack to any temperature monitor
accepting Yellow Springs Instrument series 400 probes.
3. Connection of Sorin Group Italia SAT/HCT
If desired, connect the SAT/HCT Monitor (catalog no.
050280000) to the SAT/HCT fitting on the venous inlet of the
venous reservoir. For connection instructions, refer to the
Operator's Manual for the SAT/HCT Monitor (catalog no.
050280700).
4. Vent/Vacuum Port
Remove the cap from the vent/vacuum port. If vacuum is to
be used attach the vacuum source.
5. Cardiotomy Return
Remove the protectors from the filtered cardiotomy ports and
secure 1/4" (6.4 mm) ID suction tubing to the ports. If a fil-
tered cardiotomy port is not going to be used, press in the
self-sealing protector to form a liquid seal. The protectors on
the vertical filtered cardiotomy ports are sealed if not
removed.
Attach a monitoring line to the filtered luer lock port for pres-
sure monitoring.
6. Venous Blood Inlet
Rotate the venous inlet port to the optimal position and
remove the large blue protector. Secure 1/2" (12.7 mm) ID
venous tubing to the venous inlet port.
7. Venous Reservoir Outlet
Remove the purple protector from the venous reservoir outlet
port and secure the 3/8" (9.5 mm) ID tubing going to the
pump head.
8. Recirculation Port
Remove the protector and attach the 1/4" (6.4 mm) ID recir-
culation line to the recirculation port.
9. Filter Bypass Port
The filter bypass port may be used as a return site for cardiot-
omy blood in the event the integral cardiotomy filter becomes
clogged. For cardiotomy blood, this port should be used in
conjunction with a filtered cardiotomy reservoir or a separate
cardiotomy filter and a cardiotomy reservoir.
Sorin Group Italia
®
Monitor
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10. Rapid Prime Port
The rapid prime port may be used for rapid priming when fil-
tration is not desired. It may also be used as a return site for
patient vent blood.
11. Arterial Filter Purge
If an arterial filter purge line is used, it should be connected to
a nonfiltered luer lock port.
12. Fluid Administration
Large-volume bolus or continuous infusion of drugs or fluids
may be introduced through the nonfiltered luer lock ports.
If a nonfiltered luer lock port is needed for both arterial filter
purge and drug infusion, place a three-way stopcock on the
port before attaching the arterial filter purge line.
13. Sample System
A three-stopcock manifold is connected to the venous sam-
pling port on the venous reservoir via a luer lock connection.
Connect the arterial sample line to the preferred arterial sam-
ple site of the circuit. Check the security of these two luer
lock connections.
The arterial sample line contains a one-way valve to help pre-
vent flow into the arterial line from the manifold. The manifold
may be used in its current location on the venous reservoir
cover, or it may be removed and mounted in a Sorin Group
Italia manifold holder (catalog no. 041270000). To remove, lift
upward on the manifold.
Make sure the stopcocks on the sample manifold are posi-
tioned to allow flow through and not leakage.
14. Excess Circuit Volume Removal
To provide for excess circuit volume removal during bypass,
insert a "Y" connector in the venous line and connect it to an
additional reservoir.
15. Setup of Remainder of Extracorporeal Circuit
For instructions on setup for the remainder of the circuit, refer
to the Instructions for Use for the oxygenator and other circuit
components
PRIMING THE CIRCUIT
1. Check the security of all connections; then introduce all the
priming fluid anticipated to be needed to prime the entire per-
fusion circuit.
The minimum operating volume in the venous reservoir for
cardiopulmonary use is 200 ml. However, to ensure adequate
response time in case of venous inflow obstruction, it is rec-
ommended that an adequate volume in addition to the 200 ml
minimum level be maintained.
For easier circuit debubbling, do not add non-crystalloid solu-
tions or blood products until priming and debubbling steps are
complete.
2. Start the arterial pump slowly at first to ensure all connections
are fluid tight.
Recirculate the priming fluid through the arterial-venous loop.
3. The sample system will prime itself during recirculation when
the stopcocks are positioned to allow flow through. The han-
dles point to the "OFF" position. Flow through the sample
system should be stopped when there is no flow in the
bypass circuit. This is to prevent arterial to venous shunting.
4. Non-crystalloid priming solutions, if used, may now be added
and recirculated slowly.
5. Blood products, if used, may now be added to the circuit
through a filtered port. When the priming technique employs
the use of blood products, continue recirculation through the
circuit at a minimum flow rate of 500 ml/min to minimize the
potential for thrombus formation.
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