Replacing The Cardioplegia Set - dideco VANGUARD D921 Instrucciones Para El Uso

with cardioplegic solution coming from the oxygenator, and
of the asanguineous solution line through the pump.
CAUTION
- Failure to prime the VANGUARD beyond the cardioplegia
pump head can result in air being introduced into the
arterial line of the oxygenator.
Version D924S AND D928S
Prime the blood line using physiological solution
coming from the oxygenator, open the shunt between
the blood line and the asanguineous cardioplegic solution line
and start priming through the pump.
Close the asanguineous solution line.
2) VENT THE AIR FROM THE HEAT EXCHANGER
Prime the cardioplegic solution lines and the blood line by
running pump at 50 ml/min.
Fill the heat exchanger completely then close the vent stop-
cock. Then open the stopcock on the pressure monitoring
line to atmosphere.
Open the outline.
PRECAUTION
- Failure to release the solution line clamp when the solution
reaches the top of the device can rerult in an anomalous
pressure increase which may cause the pressure relief
valve to activate.
3) VENT THE AIR FROM THE DELIVERY LINE
Open the patient delivery line. Restart the pump slowly while
directing the air out of the delivery line. When priming is
complete, clamp the line again.
The surgeon can now make the connection to the coronary
access cannula prepared and then vent the air from it.
G.DELIVERY PROCEDURE
Version BCDVAN4S ANDBCDVAN96ù
Open the asanguineous solution line.
1) Switch on the thermocirculator one minute before cardiople-
gia delivery begins.
Start pump to deliver cardioplegic solution to the patient.
Adjust pump speed to obtain the desired flow and pressure
values.
2) Costantly monitor the procedure so that the blood level in the
oxygenator venous reservoir and the quantity and quality of
the liquid in the asanguineous cardioplegic solution contai-
ner are always under control.
3) To administer further doses check that there is no air in the
circuit and repeat the procedure described in points 1. And 2.
CAUTION
- Failure to discontinue water flow may result in cold
agglutination when cold cardioplegic solution is used.
Version BCDVAN4S and BCDVANS
If administration of blood only is indicated:
- stop the pump
- open the shunt between the blood line and the asanguineous
cardioplegic solution line
- clamp the asanguineous cardioplegic solutÏtion line
- start the pump.
CAUTION
- Check carefully that the pressure is within the recommen-
ded range; different pressure values may lead to inadequa-
te perfusion or damage to the coronaries.
- The line pressure is not the same as the perfusion pressu-
re since it depends on the resistance of the delivery line
connectors and cannula. The actual perfusion pressure is
generally lower than the reading.
- The pressure inside the heat exchanger must absolutely
never exceed 98 kPa (0,98 bar/psi).
- Keep a constant check on the temperature of the cardiople-
gia solution; this temperature will depend on the flow of the
cardioplegic solution, the temperature of the cooling water,
the blood and cardioplegic solution.
PRECAUTION
- Monitor the cardioplegic delivery in terms of quantity, time,
pressure and temperature.
- Always make sure that the quantities of fluids for the
cardioplegic perfusion procedure are sufficient for the
session and to ensure troublefree extracorporeal circulation.
- Replace the asanguineous cardioplegic solution container
in good time if the amount it contains appears insufficient
for completion of the delivery procedure.
- Always monitor the system closely during the delivery of
cardioplegic solution. Air in the circuit constitutes a danger
to the patient.
H. REPLACING THE CARDIOPLEGIA SET
A spare set should always be to hand during perfusion. If situa-
tions arise in which the person in charge considers the patient
is at risk, replace the set as described below.
PRECAUTION
Use sterile techniques throughout the replacement procedure.
1) Stop the pump.
2) Place two clamps on the blood line connected to the
coronary outlet of the oxygenator (5 cm apart).
3) Switch off the thermocirculator, clamp and remove the
water lines. Clamp the asanguineous cardioplegic solution
line.
4) Clamp the vent and pressure line and disconnect the
temperature probe.
5) Place two clamps (5 cm apart) on the VANGUARD outlet line
close to the heat exchanger.
Version D924S and D928S
Ensure that the shunt between the blood line and the asan-
guineous cardioplegic solution line is clamped.
6) Cut the blood line in the point between the two clamps and
insert an appropriate connector. Cut the outlet line at the
point between the two clamps and insert a 3/16"-3/16"
connector.
7) Remove the spike from the asanguineous cardioplegic
solution containers.
8) Remove the VANGUARD and the set for replacement from
the holder.
9) Fit the new cardioplegia set. Connect all the lines (blood line
to the appropriate connector, outlet line to the 3/16"-3/16"
connector, vent line, pressure line and temperature line,
water inlet and water outlet lines). Remove the clamps from
the blood line, the outline line and the asanguineous cardio-
plegic solution line.
10)Remove the clamps from the water line and switch on the
thermocirculator; check the new BCD VANGUARD for leaks.
11)Prime the new circuit and vent any air bubbles, as described
in the priming procedure.
12) Restart perfusion.
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