Abiomed Impella 5.0 Manual Del Usuario página 9

POSITIONING AND STARTING THE
IMPELLA 5.0 CATHETER
When the Impella Catheter is not correctly placed, there is no effective
unloading of the ventricle. The patient may not be benefiting from the flow
rate shown on the controller.
1. Confirm purge fluid is exiting the Impella Catheter.
2.
While the catheter is being advanced in the aorta, the initial
placement signal is flat. The inlet area of the catheter has not passed
the aortic valve.
3.
Gently advance the catheter forward until a pulsatile waveform is
present on the placement signal screen. This signal is generated when
the inlet area of the catheter crosses the aortic valve.
4. Confirm that the controller displays a pulsatile waveform and the inlet
area of the Impella 5.0 Catheter is approximately 3.5 cm below the
aortic valve.
5.
Press the START IMPELLA soft button.
6.
Press the selector knob to select the new P-level.
7.
The catheter operation icon in the lower left corner of the screen
begins rotating when the Impella 5.0 Catheter begins to operate.
8. Increase the P-level to P-9 to confirm correct and stable placement.
Evaluate the catheter position in the aortic arch and remove any
excess slack. The catheter should align against the lesser curvature
of the aorta rather than the greater curvature. Verify placement with
fluoroscopy and with the placement signal screen.
9.
Make sure there is no bleeding at the transition from the repositioning
sheath to the femoral artery. Close and dress the wound. Secure the
repositioning sheath by suturing it to the skin using the blue suture
pads or a StatLock ® stabilization device on the sheath.
Impella 5.0 ® Circulatory Support System
10. Attach the anticontamination sleeve to the sheath. Lock it in place by
turning clockwise. Secure the catheter by tightening the connected
anchoring ring.
11. Carefully extend the anticontamination sleeve to maximum length
and secure the end closest to the red Impella plug by tightening the
anchoring ring.
12. Reposition the catheter as necessary.
13. Select the lowest P-level that will enable you to achieve the flow rate
necessary for patient support. You can select one of ten P-levels (P-0
to P-9) for the Impella 5.0 Catheter.
PURGE CASSETTE PROCEDURES
CHANGE CASSETTE & BAG
Follow these steps to change both the purge cassette and purge fluid:
1. Press PURGE MENU and select "Change Cassette and Bag" from the
menu.
2. Select START to begin the cassette and fluid change process.
3.
When prompted by the controller, disconnect the luer from the Impella
catheter. Note on Connecting Purge Tubing to the Catheter: If
included, remove and discard the y-connector and connect the yellow
luer on the purge tubing directly to the yellow check valve on the
Impella Catheter.
4.
Open the Purge Cassette door by pressing the button on the left side
of the console. Remove and discard the old cassette and purge fluid
bag.
5. Open the new Purge Cassette. Spike the new purge fluid bag with the
new purge cassette tubing. Select NEXT to continue.
6. Insert the new purge cassette into the controller. Be sure to slide the
purge disc into place and extend the purge tubing through the gap in
the purge cassette door when you close the door.
7.
Confirm the luer is disconnected. Press NEXT to proceed to prime the
purge cassette. Once the priming is complete, you are prompted to
connect the purge tubing to the Impella 5.0
8.
Update the purge fluid information.
a. To select the default purge fluid values displayed on the
screen, select CONFIRM.
b. To change the purge fluid information, select EDIT. Then use
the soft keys to navigate selections and edit values. Select
DONE to complete editing.
9.
When Steps 1 through 8 are complete, connect the luer from the new
purge cassette to the Impella catheter.
Catheter.
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