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

Rinsing of the Alteco LPS Adsorber is important to wash out the glycerin used as a stabilizer in the adsorber. The Alteco LPS Adsorber can be primed manually, or automatically when connected to the tubing in the blood pump machine circuit. If automatic priming is used, follow the machine’s instruction for use (IFU).

Manual priming takes approximately 5 minutes. The following preparation fluid is needed:

• 500 ml of 0.9% saline solution for rinsing out the glycerin;

• and 500 ml of 0.9% saline solution with 2 500 IU of heparin added to prevent clotting in the Alteco LPS Adsorber during treatment.

Alternatively:

• 1000 ml of 0.9% saline solution with 5000 IU of heparin added.

Additional equipment required for manual priming:

• 1 spike to connect the priming line to the saline bag

• 1 line to connect the top of the Alteco LPS Adsorber to a saline bag

• 1 line to connect the bottom of the Alteco LPS Adsorber to a waste bag

• 1 waste bag

Anticoagulants

Heparin should be used during priming and as a bolus dose in the system at treatment start. The product is also tested for use with citrate; however, citrate can be used during Continuous Renal Replacement Therapy (CRRT) but NOT in hemoperfusion stand-alone. The anticoagulant dose during the treatment is prescribed by the responsible physician. If Activated Clotting Time (ACT) is measured, it should be kept >180s during the treatment (however, it is normally not measured due to the short treatment time).

Access and blood flow rate

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.

The recommended flow when using the Alteco LPS Adsorber is 150 ± 50ml/min (minimum 100ml/min and maximum 200ml/min). Note: using a lower blood flow rate may increase the risk of clotting. Using a higher blood flow rate may increase the pressure and cause the blood pump to stop, interfering with the treatment.

Treatment time

The treatment time in hemoperfusion is 2 hours at the recommended blood flow rate (150ml/min). Note: the blood flow rate affects the treatment time. A lower blood flow rate means blood is filtered at a slower rate and more time is needed to filter the same amount of blood.

In early treatment using hemoperfusion, one treatment is usually sufficient. One treatment equals one adsorber.

Treatment completion

• 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.

SAFE

No contraindications
Medical device class IIa (EU MDD)

SPECIFIC

Designed to specifically
remove endotoxin

EFFECTIVE

Results in 2 hours
1 treatment = 1 adsorber