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Tue Jan 06 2009
  
 
 

 

Replacement of Blood Gas Exchange Device (BGED)

  • Disconnect new membrane from reservoir by unlocking the coupling mechanism.
  • Disconnect arterial high pressure stopcock from reservoir, making sure it is in the closed position.
  • Remove the drug ramp from reservoir.
  • Close and remove oxygenator bleed line on new membrane.
  • Test new BGED to ensure heat exchange integrity.
  • Connect one 3” length of 3/8” tubing stub with 3/8” connector to the blood inlet port and clamp.
  • To the blood outlet port connect 3” length of 3/8” tubing stub with 3/8” luer connector and clamp distal to the connector.
  • Flush new membrane with filtered 100% C02 via a three-way stopcock attached to the 3/8” connector. Remembering to release the clamp on the blood inlet and opening the arterial high pressure stopcock then closing again after flushing.
  • Retrogradely prime the new BGED with 0.5L bag of Ringers solution via a giving set attached to the three way stopcock, again releasing the clamp on the blood inlet port and opening the arterial high pressure stopcock. Reclamp the blood inlet and close the arterial high pressure stopcock when primed and closing the three way stopcock.
  • BGED IS NOW READY TO BE PLACED IN THE CIRCUIT
  • Disconnect arterial high pressure stopcock from old reservoir making sure it is in the closed position.
  • Remove old drug ramp from old reservoir and close and remove oxygenator bleed line.
  • Inform the surgeon and anaesthetist of the intention to discontinue bypass.
  • Terminate bypass in the normal manner, by clamping the venous line and simultaneously halting the arterial pump, as gas flow is turned off.
  • The arterial line should be clamped distal to the arterial filter and all bleed lines closed.
  • Double clamp the tubing close to the blood inlet and arterial outlet of the OLD membrane. Allow 2” between the clamps and using asceptic technique cut the tubing close to the proximal clamp, on both the blood inlet and arterial outlet, leaving a long enough stub to attach the new membrane.
  • Disconnect the OLD membrane.
  • Remove the gas line from the OLD membrane and attach to the new membrane.
  • Relocate the new membrane to the old reservoir and attach blood inlet and arterial outlet.
  • Clamp pre-filter. Unclamp the blood inlet and arterial outlet and circulate through the recirculation line, opening the arterial high pressure stopcock and the oxygenator bleed line.
  • Debubble if necessary and attach cable ties.
  • Remove the clamp pre-filter and purge any air out of the top of the filter.