Replacement of Hard Shell Venous Reservoir

In the event of the failure of the Hardshell venous reservoir whilst on bypass, the following procedure should be implemented:

• After informing surgeon and anaesthetist of the problem, discontinue bypass by clamping venous line and halting arterial pump simultaneously, turn off gas flow to BGED, clamp the arterial line distal to the line filter and turn off the suction pumps.
• Ask anaesthetist to check the patient’s activated clotting time (if indicated).
• Double clamp reservoir outlet tubing near the outlet, leaving 1.5 inches between clamps and, using aseptic technique, cut tube between the clamps nearest the reservoir outlet clamp.
• Connect the reservoir outlet pipe to the new reservoir and take the clamp off.
• Disconnect the remaining tubes from the old reservoir.
• Clamp the venous line next to the venous inlet, remove and connect to the new reservoir venous inlet; remove suction tubing from old reservoir and connect to new reservoir.
• Close and transfer arterial filter bleed line (if applicable) to port on new reservoir and transfer sample system, if necessary.
• Clamp and transfer recirculation line from old reservoir to new reservoir.
• To the new reservoir, add 5,000 units heparin.
• Flush the heparin through with enough Ringers to prime the venous reservoir up to the minimum level.
• Turn suction pumps back on.
• With hardshell venous reservoir, unclamp recirculation line and recirculate for a brief period, debubbling as necessary. Once satisfied the circuit is air free, turn off arterial pump, clamp recirculation line and reinstitute bypass in the usual manner, opening arterial filter bleed line concurrently.
• Note the period of cessation of bypass in the perfusion record.