Short instruction for membrane plasmapheresis

Line System Assembly

1.Open pinch valves on the device; take protective cap over pump segment off.

2.Open general package, then the package with line system, package with plasma off-take line, package with plasma collection container. Open the package with plasmafilter. 

3.Install plasmafilter in the its holder on support stand, red connection down.

4.Place line system on the device with singular pump outlet located on the right, and tubing with two fittings on the left.

5.Install pump segment (thick tube) into its channel in pump compartment.

6.Without sorting the tubing choose the tube going fr om the pump to plasmafilter, fix it in the first track of the right pinch valve, accurately mount the long end with the hydrophobic filter to the fitting of the manometer in the back part of the device, then fix this segment in the pin of the plasmafilter holder, and mount the shorter end to the lower (red) fitting of the plasmafilter.

7.Without sorting the tubing take initial parts with fittings and mount them in the left pinch valve so that there are no excessive bends in the short sections, mostly the section going into the pump segment.  Fix the cap of the left pinch valve. 

8.Take the tube of anticoagulant line with dosing bag and install it in the small  gap of bag holder in the position of liquid going bottom-up, then mount the tube in the second track of the right pinch valve. Close the clamp on the tube and fix its filter-dropper between hooks of right bottle holder of the plasmafilter holder.

9.Take smaller tube for supplying normal saline, close the pinch and fix its filter-dropper between hooks of left bottle holder.

10.From the remaining tubing take the air trap filter, take it in your left hand, raise it high and put down  the clamp next to it (return line) to 10-15 cm from infusion node and close it. Raise the infusion node and take it in your left hand as well, and put down the clamp of blood intake line to the level of 10 cm from the left clamp valve and close it.

11.Mount infusion unit on the hook of the left  holder of normal saline, and ins ert the air trap into its node on the plasmafilter holder and fix it there. Then mount the continuation from the air trap of return line in two pins over the volume sensor for air control, adjust the tube so that it connects tightly to this sensor.

12.Take the plugs off the short tube of the air outlet from the air trap (leaving the clamp open) and from the longer tube, which, taking the blue cap off in the upper part of the plasmafilter, tightly screwed to the corresponding fitting. Take plasma sampling line and relocate the clamp to the level of 10 cm from the other end thereof which is connected to a plasma collection reservoir limb. Take off the white cap of the plasma sampling line and the white cap of the central fitting of the plasmafilter and connect the tube to the appropriate fitting.

System filling

1.Take the cap off the right filter-dropper and ins ert it in to the reservoir with citrated anticoagulant (ACD-A). Open the clamp at the anticoagulant supply line and visually trace its movement to the level of pump tube, then close the clamp.

2.Take a syringe with 2,5 ml of heparin and insert 0,5 ml in the container with normal saline taking from it solution to 5 ml.

3.Insert the left filter-dropper in to the container with normal saline and fill it completely with the solution. Open air channel in the filter-dropper (if it is a plastic container do not open the air channel) and open the clamp of the return line before the moment of filling with solution  2-4 cm below this clamp. Close the clamp.

4.Open the clamp on the intake line and fill it to the pump segment. Close this clamp.

5.Open clamp under left container for normal saline and direct the solution to the pump segment. Left end of the pump tube is pressed down and the right is lifted in order to completely fill the tube, after which the tube is precisely placed in its channel. Mount the cap over pump compartment.

6.Turn the device on (electric switch is in the back part of the device).

7.Device is turned on automatically in the “work” mode and is not turned on with “empty” air trap. So at the start press “Pumping” button and only after that press “Start” and prepare to close the clamp of the air channel while the air-trap is filled with solution. Close the clamp.

8.Open clamp of the return line and continue filling of the final part of the line up to infusion unit.

9.Stop the device. It automatically switches to “Work”.  Start. If the display shows – “intake – return time”, it means that everything is taken and filled correctly. Stop. Close the clamp of the return line. Device is ready for work.

Preparation for plasmapheresis

1.Put manometer cuff on the shoulder and check arterial pressure. Pump the cuff to the level of 70-80 mm Hg. Find optimal place for venepuncture. Treat it with an antiseptic and insert venous catheter. When blood shows in the control point, fix the needle, and insert catheter deeper along the vein. Ease off the cuff. Mount “wings” of catheter with a line of adhesive bandage. 

2.Take infusion unit from the container with normal saline, take out the needle. Press down the place wh ere the end of catheter is located and take out the its needle. Tightly attach infusion unit to the venous catheter. Fix infusion unit with the second line of adhesive bondage.

Remove part of solution from left filter-dropper and open clamp under it. Open clamp at the line of “Intake”. Movement of solution along the appropriate intake tube indicates normal placement and passability of venous catheter. If necessary, the catheter is inserted through a previously prepared solution of heparin.

3.Close the left clamp at the normal saline line and open the right clamp at the anticoagulant line. Device is ready to be turned on.

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