Abiomed Impella 5.5 Manuel Utilisateur page 8

PRE-SUPPORT EVALUATION
Before initiating the procedure, evaluate the patient for factors that
may prevent successful placement of the Impella Catheter. Use imaging
technology to examine the patient's vasculature access site. An echo
assessment of the left ventricle is also recommended to rule out left
ventricular thrombus, mechanical aortic valves, or severe aortic insufficiency.
Consider inserting a diagnostic Pulmonary Artery (PA) catheter to provide
continuous hemodynamic monitoring, including pulmonary artery and central
venous pressures, measurement of cardiac output, and SvO
STARTUP
SUPPLIES NEEDED
• Automated Impella Controller (Abiomed)
• Impella 5.5 ® with SmartAssist ®
• Hospital Provided:
• Diagnostic catheter (AL1 or MP without side holes or pigtail without
side holes)
• 500 cc bag of glucose solution for purge solution in water
(5% recommended; 5% to 20% acceptable) with heparin (25 or 50 IU/mL)
or sodium hydrogen carbonate (25 or 50 mEq/L)
• 10 mm polyester fiber woven graft proven suitable for this application,
e.g. Hemashield Platinum or Vascutek Gelweave
Note: If the purge solution is supplied in bottles, open the vent on the purge
fluid spike and follow the same procedure as if supplied in bags.
CASE START
If you miss a step in the process of setting up the Impella Catheter, or if
you exceed the amount of time allowed to complete a step, the Automated
Impella Controller will display additional instruction screens for continuing the
setup process for some steps. For the steps discussed below, all shaded steps
require sterile technique.
1. Press the START NEW CASE soft button from the startup screen or
plug in a new Impella Catheter. "Case Start" can also be selected by
pressing the MENU soft key.
2.
The controller displays the screen shown below.
4
.
2
Set (Abiomed)
INSERT PURGE CASSETTE
1. Open the purge cassette package.
2.
If included, discard the purge extension line and secure the yellow luer
connector on the purge tubing.
3. Spike the glucose bag/bottle.
4.
Press the NEXT soft button to continue.
5.
Open the purge cassette door by pressing the release on the left side of
the controller.
6.
Insert the purge cassette into the compartment on the front of the
controller. Follow the diagram on the inside of the purge cassette door
for proper placement.
7. Slide the purge disc into the slot to the right of the purge cassette
until it snaps into place. The controller will automatically begin
priming the purge cassette.
8.
Extend the purge tubing and close the purge cassette door. There is
sufficient room around the edges of the purge cassette door so that it
will not pinch the purge tubing as it exits.
9.
The controller automatically begins priming the purge cassette after it
is inserted. The progress bar marks the progress of the purge cassette
priming.
CONNECT THE IMPELLA CATHETER
1.
Remove the Impella Catheter from its package using sterile technique
and inspect the catheter for damage.
2.
Inspect the cable for damage, including damage to the connector pins at
the controller end.
3.
Pass the sterile connector cable from the Impella Catheter off the sterile
field.
4. Open the cover on the blue catheter plug by rotating clockwise. Line
up the notch on the connector cable with the notch in the blue
catheter plug on the front of the Automated Impella Controller and
plug the cable into the controller.
5.
Once the purge cassette is primed and the controller detects that the
connector cable is plugged in, it prompts you to connect the luer to
the Impella Catheter.
User Manual