The Alteco LPS Adsorber can be prepared using the acute blood purification system’s priming procedure, or through manual rinsing and priming.
Rinsing and priming procedure of the Alteco LPS Adsorber
The purpose of the rinsing procedure is to flush out the glycerin from the product, used as stabilizer during transportation and storage.
• Inspect the Alteco LPS Adsorber for shipping damages.
• Only use the product if its sterile packaging is intact.
• Remove the product from its packaging and insert it vertically into a holder.
Always follow the instruction for use (IFU) of the blood purification system together with the Alteco LPS Adsorber IFU regarding rinsing/priming volumes and anticoagulantia.
Connect the Alteco LPS Adsorber to the machine manufacturer’s blood lines.
Manual priming takes approximately 5 minutes. The following preparation fluid is needed:
• 1 bag of 500 ml of 0.9% saline solution;
• and 1 bag of 500 ml of 0.9% saline solution with 2 500 IU of heparin added into the bag.
• 1 bag of 1 000 ml of 0.9% saline solution with 5000 IU of heparin added into the bag.
Additional equipment required for manual priming:
• 1 spike to connect the priming line to the saline bag.
• 1 line to connect to the product at the top and to the saline bag.
• 1 line to connect to the product at the bottom and to a waste bag.
1. Connect a rinsing line including a waste bag to the lower port at the bottom of the Alteco LPS Adsorber (see picture 1).
2. Connect a priming line to the upper port on the top of the Alteco LPS Adsorber (see picture 2).
3. Connect the other end of the priming line to a spike and the into the 1st bag of 500 ml I.V. saline (0.9%) solution. Let the 500 ml I.V. saline (0.9%) solution pass through the Alteco LPS Adsorber by gravity (see picture 3). Now the glycerin has been washed out.
4. Remove the empty saline bag and connect the second bag of 500 ml I.V. saline (0.9%) solution with 2 500 IU of heparin added. Turn the Alteco LPS Adsorber upside down – this makes it easier to remove any air. Let the 500 ml I.V. saline (0.9%) solution with heparin pass through the Alteco LPS Adsorber by gravity (see picture 4).
5. Remove any residual air from the blood path of the product by gently shaking it.
6. After the priming procedure, turn the Alteco LPS Adsorber product again, to maximize the flow distribution within the product during treatment.
7. Disconnect the Alteco LPS Adsorber from the lines and insert it into the treatment circuit that will be used.
A double lumen dialysis catheter of size 12-14F is required to obtain sufficient blood flow rate of 150 ± 50 ml/min. A femoral Seldinger catheter can also be used.
Anticoagulantia during treatment
• high molecular heparin (heparin)
• low molecular heparin (Fragmin, Innohep, Klexane etc)
Treatment initiation and duration
• Connect machine blood lines to appropriated venous access.
• Ensure that all clamps that should be open are opened.
• Inject a bolus dose of heparin into the system (red port on the arterial line), prescribed by the responsible physician.
• Start the blood pump and increase gradually the blood flow rate to 150 ± 50 ml/min.
• To avoid the risk of blood clotting in the system, the blood pump should never be stopped during the Alteco LPS Adsorber treatment.
• The recommended treatment time with Alteco LPS Adsorber is two hours and normally only one treatment is needed. However, the product can be used for up to 6 hours and treatment can be repeated if needed.
• Stop the blood pump and connect a 500 ml saline bag for rinse back.
• Start the pump at 100 ml/min and return the blood to the patient.
• Disconnect the patient from the system.
• Dispose the blood lines used with the Alteco LPS Adsorber in regular waste for blood disposal.