sorin Xtra Serie Instrucciones De Uso página 6

 If during an emergency XVAC is required while the XTRA OS boots
up, the aspiration can be controlled directly from the control panel
present on the XVAC vacuum system (refer to chapter 13 of XTRA
Operator's Manual for detailed information), until the boot up is
finished. Then, it will be controlled only from the XTRA screen.
b) If using XVAC vacuum system stand alone:
b.1. Make sure the power switch on the back of the unit is on ON.
b.2. Turn on XVAC using the ON/OFF switch present on the control
panel
b.3. Regulate the level of vacuum from the control panel
c) If using a vacuum regulator
c.1. Switch on the vacuum regulator
c.2. Close all the lines apart from the vacuum line with a clamp (the
aspiration line and the Y adapter if present) and regulate the
vacuum level.
c.3. Then, reopen the lines, keeping the vacuum on.
SORIN GROUP ITALIA recommends not to exceed a negative pressure of -

150 mmHg (20 Kpa/0,2 Bar/-2,9 psi) during recovery procedure as an
excess vacuum increases hemolysis of the recovered blood
2. Regulate the vacuum at a level no greater than 150 mmHg (20 kPa) in
accordance with the AABB guidelines.
3. Verify that the protective cover on the end of the suction line in the sterile field
has been removed and that the aspiration tip is open to the atmosphere (not
blocked).
4. With the vacuum system ON, open the roller clamp on the small bore tubing and
allow 200 ml of anticoagulant solution to be drawn into the reservoir before
starting blood collection. This volume should ensure adequate wetting of the
blood contact surfaces. Close the roller clamp if there will be any delay before
processing.
5. After the transfer of the anticoagulant solution to the reservoir, adjust the flow
rate of the anticoagulant solution to between 60 and 100 drops a minute. The
lower flow rate is suitable for ACD-A or CPDA-1 and the higher rate for heparin.
In case of heavy bleeding, appropriately increase the rate.
NOTE: The flow of anticoagulant into the reservoir is manually controlled by the roller
clamp on the anticoagulant line. This flow must be adjusted to the rate of blood
collection from the surgical field. If the rate of collection varies without adjusting the
flow of anticoagulant, the ratio of anticoagulant to blood can be too low or too high.
The blood in the reservoir may clot if there is too little anticoagulant.
 In the event of excess heparin in collection reservoir due to inappropriate
ratios, the savaged blood may contain residual heparin.
 In the event of decreased patient antithrombin III levels if using heparin
anti-coagulation, consult the physician in order to provide alternate
anticoagulation.
When in the need of transferring into the reservoir unfiltered blood coming

from another source, use the filtered luer lock connection.
Failure to maintain adequate anticoagulation during blood collection can

cause excessive clotting and possible clogging of the collection reservoir
or centrifuge bowl.
 Prior to collecting any blood, prime the reservoir with approximately 200
mL of the anticoagulant solution.
 When an anticoagulant solution using ACD-A pr CPDA-1 is used during
blood recovery, do not use ringer lactate solutions in subsequent wash.
The XRES Blood Collection Reservoir is equipped with three graduated scales 180°
angled to allow the operator to monitor the level of fluid present inside the reservoir
from any position. The indication provided by the graduated scales must be
considered only as a gross indication of the fluid contained in the device.
The XRES Blood Collection Reservoir is equipped with a Safety level valve device for
interrupting aspiration and preventing the blood collected from entering the vacuum
line. Should this safety level valve activate, follow the instructions below to reset
aspiration to the operative field:
1. Temporarily switch off the vacuum and process the fluid contained in the
reservoir until the level ìs below the safety valve.
2. Pull the yellow tab located on the connector marked VACUUM and check that
the valve has dropped down in the guide.
3. Release the yellow tab and reset aspiration.
A pressure relief valve is provided to prevent implosion of the device if

exposed to a sudden, deep vacuum
The negative pressure inside the XRES B Blood Collection Reservoir
o
must not exceed -300 mmHg (40 KPa/0.4 bar/5.7 psi).
Check the cap seals of the connectors not in use, pushing them fully
o
on.
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Do not occlude the safety valve release present on the XRES Blood
o
Collection Reservoir with foreign bodies to prevent the potential
possibility of implosion
Using the XRES Blood Collection Reservoir connected to a Bowl Set
1. When ready to start processing, connect the Bowl Set inlet port (on the fill line,
blue color) to the XRES Blood Collection Reservoir outlet port:
a. marked WASH and covered with a blue cap, for a XRES T Blood
Collection Reservoir
b. located on the bottom of the XRES B Blood Collection Reservoir with the
blue cap. Once done, open the clamp on the bottom outlet port.
2. In case a Y adapter is used (Collection Set Cardio), connect the Bowl Set inlet
port (on the fill line, blue color) to the Y adapter male branch and open the
corresponding clamp. Keep the clamp on the other branch of the Y adapter (for
connection to the Oxygenator Extension Line) closed.
3. Proceed with further steps for blood processing according to the instructions for
use contained in the operator's manual of the cell separator
Concentration of priming fluid during ECC (for Collection Set Cardio only)
1. Isolate the Y adapter from the reservoir, by closing the 1/4" tubing segment
connecting the Y adapter to the reservoir with a clamp. Open the clamps
located on the Y adapter branches.
2. Remove the clamp used on the 1/4" Adapter Tubing previously connected to
the ECC circuit and open any other clamp that may be present on the
Oxygenator Extension Line.
3. Whenever the Oxygenator Extension Line is directly connected to the Bowl Set,
ensure that all the clamps are open.
4. Transfer the priming fluid to the cell separator device following the instructions
for use of the device, taking care not to create any negative pressure within the
ECC circuit.
5. During the return of the concentrated priming fluid, avoid any air being routed
to the ECC circuit.
Recovery of priming residue from the ECC circuit (for Collection Set Cardio
only)
During cardiovascular operations, it is advisable to transfer the priming residue from
the ECC circuit to the reservoir, to minimize the time the pump console remains in the
operating theatre.
1. Clamp the aspiration line
2. Open both clamps on the Y adapter branches. Make sure the ¼'' tubing
segment connecting the Y Adapter to the reservoir is open. Remove the clamp
used on the 1/4" Adapter Tubing previously connected to the ECC circuit and
open any other clamp that may be present on the Oxygenator Extension Line
3. Transfer the priming residue to the reservoir from the ECC circuit until it is
completely empty, appropriately adjusting the vacuum.
4. After transferring the priming residue to the reservoir, close all the clamps
between the Y Adapter and the ECC circuit and remove the connection to the
circuit. The pump console is now free of connections and the blood processing
can start.
5. Reopen the aspiration line
 Wash the recovered blood with at least the volume of saline solution
recommended in the instructions for use of SORIN GROUP ITALIA cell
separators for autotransfusion, to guarantee removal of excess
anticoagulant and other undesired components collected.
REINFUSING SALVAGED BLOOD
 It is recommended that intraoperative and postoperative autologous blood
be processed. The washing operation is necessary whenever the recovery
is carried out in the presence of heavy hemolysis caused by surgery, or in
cases of high coagulopathy or hepatic or renal failure.
 The decision to re-infuse the blood components obtained by this
concentration-washing procedure is the responsibility of the attending
physician.
 Do not reinfuse the patient's blood from the primary reinfusion bag when it
is connected to the cell separator's wash circuit. Reinfusion from the
primary reinfusion bag connected to the circuit could lead to air embolism
to the patient.
 Do not reinfuse under pressure (i.e., do not use a blood pressure cuff on
the secondary reinfusion bag). Reinfusion under pressure could lead to air
embolism.
To minimize the complications of particulate matter infusion, use of an in-

line microaggregate filter on the patient reinfusion line is highly
recommended. Failure to use an in-line filter may result in reinfusing
particles potentially harmful to the patient.
 To reduce risk of air embolism, remove all air from the primary reinfusion
bag before handing the bag over for reinfusion.
 The American Association of Blood Banks recommends the following
guidelines for expiration of salvaged blood
GB – ENGLISH
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