Spectra Optia Apheresis System White Blood Cell Depletion Procedure Training Rev June 2014

Presentation Overview  Introduction

 Preparing to Perform the Procedure  Monitoring the Run  Completing the Run  Making Changes  Optimization

 Troubleshooting  Pediatric/Low TBV Patients

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Spectra Optia System WBCD Training

Introduction  IDL Set

 Diversion Bag  Basic Principles of the Procedure-Flow Path  Cell Separation in the Connector  Basic Principles of the Procedure-Channel  Automated Interface Management (AIM) System Control of Collection

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Spectra Optia System WBCD Training

Introduction

IDL Set 1. Replace line  Frangible connector 2. Collection bag  Spike port  Sample bulbs  Sterile barrier filter 3. Connector 4. Cassette 5. Colored spikes and tubing  Sterile barrier filters 6. AC check valve 5 7. Colored clamps 8. Diversion bag

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Spectra Optia System WBCD Training

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Introduction

Diversion Bag Can be used to capture a skin plug after performing a peripheral venipuncture, or to collect a blood sample at the start of the procedure. 1. Prime the inlet line to the appropriate place. 1.1 When not using the diversion bag for blood samples. 1.2 When using the diversion bag for blood samples. 2. Perform the venipuncture. 3. Unclamp the line to the diversion bag. 4. Allow blood to flow into the bag. 5. Clamp and seal the line to the bag. 6. Unclamp the inlet line. 7. Touch Start Run. 8. Remove the bag.

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Spectra Optia System WBCD Training

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Introduction

Basic Principles of the Procedure-Flow Path

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Spectra Optia System WBCD Training

Introduction

Cell Separation in the Connector

 Centrifugal force separates the blood in the connector into layers based on the specific gravity of the cells. Platelets: 1.04–1.08 Monocytes and Lymphocytes: 1.06–1.09 Granulocytes: 1.07–1.08 RBC: 1.08–1.11

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Spectra Optia System WBCD Training

Introduction

Basic Principles of the Procedure-Channel 1. Whole blood enters the channel. 2. Red blood cells (RBC) flow to the reservoir. 3. Plasma is pumped to the reservoir.

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Spectra Optia System WBCD Training

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4. Cells are continuously pumped into the collection bag.

Introduction

AIM System Control of the Collection 1. The AIM system controls the concentration of cells in the collect port (collection preference).

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Spectra Optia System WBCD Training

2. When cells are detected in the collect port the collect valve moves to the collect position.  The cells are continuously collected into the collection bag

Questions?

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Spectra Optia System WBCD Training

Preparing to Perform the Procedure  Selecting the Procedure

 Configuration-WBCD Procedure  Configuration-Blood Warmer  Channel Loading  Patient Data  Run Values-Replacement Fluid Option

 Spiking of Replacement Fluid  Patient Connection

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Spectra Optia System WBCD Training

Preparing to Perform the Procedure

Selecting the Procedure  Ensure IDL filler is installed

 Use IDL set with this procedure

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Spectra Optia System WBCD Training

Preparing to Perform the Procedure

Configuration-WBCD Procedure

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Spectra Optia System WBCD Training

Preparing to Perform the Procedure

Configuration-Blood Warmer

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Spectra Optia System WBCD Training

Preparing to Perform the Procedure

Channel Loading (very important) 1. Centrifuge collar is in the correct position. 2. Notch on locking pin is visible.

3. Optical reference is visible.

4. Connector and channel sit flush in the filler. 5. Section of IDL filler has a black square.

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Spectra Optia System WBCD Training

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Preparing to Perform the Procedure

Patient Data

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Spectra Optia System WBCD Training

Preparing to Perform the Procedure

Run Values

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Spectra Optia System WBCD Training

Preparing to Perform the Procedure

Run Values-Replacement Fluid Option  Target Fluid Balance (%)  Replacement Fluid 

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Note the collect volume and whether there is a need to attach additional collection bags.

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Spectra Optia System WBCD Training

Fluid Type 

No Fluid

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Saline/Albumin

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Plasma

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Custom

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RBC

Volume (mL)

Preparing to Perform the Procedure

Spiking of Replacement Fluid  If the use of replacement fluid was chosen, these screens will appear at the appropriate time.  Spike the appropriate replacement fluid.  Break the frangible by bending it back and forth.  Make sure the IV pole is extended to its highest point.  Do not use a filter. Caution: Once the frangible is broken, the tubing set is no longer considered functionally closed.

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Spectra Optia System WBCD Training

Preparing to Perform the Procedure

Patient Connection Important

 Unclamp and close the lines as instructed on the screen.  Leave the return saline line open at the start of the run to divert the prime saline. 21

Spectra Optia System WBCD Training