Dialysis System SW 8.09.13

Training module 10 – Single Needle Double Pump

Ref: Operator’s Manual SW 8.09.13-­ Chapter 6: HD-­SN Treatment

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HD-­SN Double Pump

Important Notice:This presentation does not relieve any user of the Artis Dialysis System from his or her duty to carefully read the full text of the Operator ’s Manual before using the system.

Important:Please note that the SW change to 8.09.13 of this presentation does not change the training of the Artis DialysisSystem for the user.

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SNDP Principle

Arterial phase;; Arterial blood pump (Art_BP) is running until the automatically calculated post dialyzer pressure limit is met (SN pressure max) -­ venous line is clamped (VC)

Venous phase;; Venous blood pump (Ven_BP) is running until the fixed low system pressure limit is met. (SN pressure min) -­ arterial line is clamped (AC)

SN cassette

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Programming HD-­SN DP on Artis

Always set the HD-­SN Treatmentbefore starting the HD-­SN cassette loading procedure

1. Select treatment type 2. Confirm parameters

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HD-­SN DP

HD SN HC

Priming performed in SN

Patient ConnectionSN or DN

Special ProceduresSN à DNDN à SN

Needle mode switch is available, from Connect Patient until Stop Treatment keeping the SN cassette installed

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Switching from SN to DN (DP) …

Control loop on Venous pump with system pressure fixed at 100mmHg when in Double needle Double pump mode

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… and from DN to SN (DP)

Needle mode switch is possible as many times as needed

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SNDP ArtiSetDialyzer Art. line

Post dialyzerExpansion Chamber

Pre dialyzerExpansion ChamberDialyzer Ven. line

SN Service lines

• Integrated blood circuit including 2 expansion chambers and a venous pump segment

• Automatic loading of the complete blood circuit

• Automatic priming and chamber level adjustment

The fluid level in the post dialyzer chamber is normally quite low

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Blood Levels in the ChambersBlood level adjustment during SNDP treatment

1. Arterial chamber • During the arterial phase when the arterial automatic clamp is open 2. Venous chamber • During the venous phase when the venous automatic clamp is open3. Expansion chambers (if blood levels in the two expansion chambers become greatly different;; e.g. after an alarm situation):

• Decrease the “Stroke Volume” to 20 ml and the “Mean Blood Flow” to 50 ml/min and wait at least one cycle (arterial + venous phase) before stopping the blood pumps

• Attach a sterile luer-­lock syringe (at least 20cc) to the Service Line on the expansion chamber with the higher blood level and gently adjust by pushing or pulling the blood level in accordance with the other expansion chamber

• Restart the blood pumps and adjust the Mean Blood Flow and “Stroke Volume”

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SNDP Parameters

Mean blood flow rate The effective blood flow rate during one cycle (20 to 270 mL/min, 10 mL/min step)

Stroke volume The volume of blood passing through the dialyzer during a cycle (20 to 60 mL, 5 mL step)

SN pressure max Automatically calculated in accordance with the set stroke volume

SN pressure Actual pressure in the post dialyzer chamber

SN pressure min Fixed at 40 mmHg

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• Mean Blood Flow directly adjustable with BP hard keys

• Stroke Volume value box

Treatment Overview Screen

Adjustable mean blood flow

200

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Blood Settings Screen

Adjustable Stroke Volume

• Stroke volume set button (also available on Prescription screen)

• Stroke Volume value box• Arterial and Venous pressure values and trend graph

• Blood Settings button

200

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Stroke Volume

+= 40ml

Arterial Phase Venous Phase

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Blood Settings sub-­screen

The Mean Blood Flow is automatically recalculated when Arterial or Venous Flow values are changed

• Arterial flow set button• Venous flow set button

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• SN Pressure Max, dependant of the stroke volume

• SN Pressure, post dialyzer chamber pressure

• SN Pressure Min, fixed at 40mmHg

Usually the venous pump runs about 30% faster than the arterial pump as it is easier to return blood faster -­ it also decreases cycle time

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SNDP Supervision

Operator control: Mean blood flow and Stroke VolumeArterial and Venous flow adjustment (blood pump speed) for fine-­tuning

System control: Post dialyzer pressure management;; auto adjustment of pump speed and pressure threshold

Safety system: Pressure monitoring and Time-­cycle

During Rinseback the A/V pumps run synchronously

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Nice to Know

• Functions available with SNDP – Diascan*, Hemoscan, Isolated UF (*=accuracy not guaranteed for SN: blood pump does not run as fast as in double needle mode resulting in a decreased volume of blood cleared/processed)

• The fluid level in the SN Venous Chamber is normally quite low

• The Blood setting button becomes available at blood detection

• When the Blood Setting sub-­screen is open, the BP hard keys and are disabled

• When a SN parameter is changed, 3-­4 cycles are required for the change to become valid

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Nice to Know –Switching Needle Mode• Isolated UF, Hemoscan and Diascan* are available when the

treatment is started in HD DN (SP/DP) or SN DP mode. (*=accuracy not guaranteed for SN)

• The Isolated UF function must be deactivated before switching Needle Mode (not available in the Select pad) and cannot be reactivated after the switch.

• HemoControl is available when the treatment is started in DN. When switching to SN (DP or SP), HemoControl is deactivated upon the Operator’s confirmation of UF rate and dialysis fluid sodium concentration.

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Hands on Module 10-­ SNDP-­ Switch between the needle modes

Abbreviations for productsHD SN DP: Hemodialysis Single Needle Double PumpHD DN HC: Hemodialysis Double Needle HemocontrolHD DN DP: Hemodialysis Double Needle Double Pump

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For the safe and proper use of the devices referenced within, refer to Warnings, Precautions and the complete Instructions for Use or the appropriate manual

avaialble by contacting customer support

ArtiSet, Diascan, Hemoscan and Hemocontrol are Trademarks of Gambro AB. Gambro is an indirect subsidiary of Baxter International Inc.

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