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Leakage sensors cleaned. Check valve for heat exchanger (A05) checked for proper function. Rotor position (blood pump) checked.Measured values are plausible. Single Needle 6.5.1 Rotor position (Single Needle) checked.Disinfection performed.The associated Information window will be opened automatically.M32 403 1) available from Fresenius Medical Care.If the pressure limitation is not within the desired range, it must be adjusted using A01.If the pressure limitation is not within the desired range, it must be adjusted using A02.Touch the OK button to confirm the value entered. Touch the Accept value button. The CALIBRATE SCREEN will be displayed.When the blood leak detector has been calibrated, the CALIBRATE SCREEN will be displayed. OCM (option) Before calibrating the OCM, the temperature must have been calibrated.Touch the Start calibration button. Automatic OCM adjustment. When the OCM detector has been calibrated, the CALIBRATE SCREEN will be displayed.An alarm output for the nurse call is also present.A control chip with pulse-duration modulation controls the heater rod via two triacs. The data required for the control is sent via the CAN bus to the processors.In the EBM it is used to control the arterial and the venous pressure measurement unit. In the hydraulics unit, the pneumatic unit is required for the membrane integrity test and for the filter change program.An impermeable elastic membrane separates the used from the fresh dialysate.Caution: If a previous version of the PC Service Software 5008 is already installed on the computer, this version must be uninstalled. Make sure this version is completely uninstalled before installing the new software. Click Start to install the driver.Caution: The interface cable for the RS232 connection is not a standard cable. It is therefore imperative to use the enclosed interface cable (M35111). This is checked by the PC Service Software 5008 and the associated Service card. The Service card is read out via: 1.

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To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to upgrade your browser. You can download the paper by clicking the button above. Related Papers Care Fresenius Medical By mohd bulyan Online Hemodiafiltration: A Multipurpose Therapy for Improving Quality of Renal Replacement Therapy By Bernard Canaud On-line haemodiafiltration: state of the art By Bernard Canaud Online Hemodiafiltration By Bernard Canaud Effect of online hemodiafiltration on morbidity and mortality of chronic kidney disease patients By bernard canaud READ PAPER Download pdf. Electrically isolated by transformer. Port: RJ 45 RS232 Interface for the exchange of data. Electrically isolated by optocoupler.Reinfusion Reinfusion volume adjustable in the SETUP. Return to dialysis still possible.The data transfer of alarm states via the network must not be used as an external alarm alert (nurse call).Any information on initial start-up and the specifications in the Operating Instructions must be observed. Apply a shrink tube marking for the CDS tubings.Basic requirements: Flow on. Perform the degassing adjustment.Check the arterial pressure display.For profiting from this possibility, observe the following notes.BPM (Can only be selected if the device option exists.) Submenu Default value Value range. Do not touch live parts (e.g. connectors of the power cord or heater).Every 4 years only: Battery replaced.Disinfection performed.Disinfection connectors; warning of cauterizing risk.Check the brake. Check EBM, concentrate connectors, filter chamber, and complete hydraulics (e.g. leaks, corrosion, broken parts, loose parts).Check engagement and microswitch. Seal of rinse chamber replaced. Replace seal and iron ring.Grease O-rings before installing them. After installation, the mark must be at the top.Hydraulics unit Loading pressure of balancing chamber checked. This pressure should be measured in the course of maintenance procedures.Disinfection performed.

Report this Document Download Now Save Save Fresenius 4008 HDF Hemodialysis System - Technical. For Later 100% (8) 100% found this document useful (8 votes) 4K views 104 pages Fresenius 4008 HDF Hemodialysis System - Technical Manual Uploaded by chanlal Description: Full description Save Save Fresenius 4008 HDF Hemodialysis System - Technical. For Later 100% 100% found this document useful, Mark this document as useful 0% 0% found this document not useful, Mark this document as not useful Embed Share Print Download Now Jump to Page You are on page 1 of 104 Search inside document Browse Books Site Directory Site Language: English Change Language English Change Language. Fresenius Dialysis Machine Service Manual Fresenius Dialysis Machine Service Manual PDF. In order to cut tractor models with 6 speed and Trans PTO: line, prepared with glue and powdered glass covers some length of the kite line or wire. Hemodialysis machine and related devices, dialyzers, blood tubing sets, hemodialysis communication systems, blood glucose controller, etc. June 8, 2017 Fresenius Medical Care sees excellent prospects for further growth and launches a new Global Efficiency Program at its Capital Markets Day 2017. Audible Download Audio Books. All steel construction with CK Construction King Tractor Parts Catalog. Learn more about our PD dialysis systems. Fresenius Dialysis Machine Service Manual from instagram. Book's Motor biker Discussions: backlit buttons for night springs this adapter is silentImMar 19, 2014. Get your parts fast: 162 pages. Fresenius Dialysis Machine Service Manual. You may try more than one type of dialysis. TekMed provide premium medical products to the Australian, New Zealand and Asian healthcare markets. Get your parts fast: plated handles, pins and 31 pages.CASE Model 480CK 480. MF 114 and 116 All orders ship within most of our manuals. Fresenius Dialysis Machine Service Manual download. Fresenius Dialysis Machine Service Manual. Dialysis related.

the Service Card Reader on the PC. Modem Connection: Selection of the modem. The modem must be configured in the Window Control Panel.If the 5008 (network setup) is in the PC Service mode, IP address 192.168.0.5. must be set. Caution: For a direct connection via a network a Cross- Over patch cable (M36433) is required. Open views: In this field, the currently open views are listed. The active view is checked.Downloads machine information from the 5008 and saves them to a file. Uploads the selected operating hours (example above: complete system and monitor OS) to the 5008. Deletes the selected operating hours (example above: complete system and monitor OS) of the 5008. Clicking the button will upload the time set by the operator to the 5008. Clicking the button will upload the current time of the PC to the 5008. Informs the operator of. Opens a file and uploads, depending on the selection of the operator, the entire NOVRAM data or only the calibration data to the 5008.Checkboxes where the operator can select for which assemblies the NOVRAM data are to be downloaded, to be deleted, to be displayed or which data are to be uploaded to the 5008. Service-PC active must be selected if the PC Service Software 5008 is to be used for network communication with the 5008. The operator can view, edit and save the network settings of the 5008 and upload them with all other setup data to the 5008. Dimmed assemblies have been reported by the 5008 as not present. Shows the error memory data. - Error Code: error code of the 5008. Caution: The service data recorder files have not yet been downloaded from the 5008. Deletes the service data recorder files selected under from the Compact- Flash. Current file size of the selected service data recorder files. Deselects the selected service data recorder files or selects all.Displays the Print Preview. Discover everything Scribd has to offer, including books and audiobooks from major publishers. Start Free Trial Cancel anytime.

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Report this Document Download Now Save Save 4008S Service Manual For Later 82% (17) 82% found this document useful (17 votes) 2K views 595 pages 4008S Service Manual Uploaded by Ramanjaneya goud Description: 40008S SERVICE MANUAL Full description Save Save 4008S Service Manual For Later 82% 82% found this document useful, Mark this document as useful 18% 18% found this document not useful, Mark this document as not useful Embed Share Print Download Now Jump to Page You are on page 1 of 595 Search inside document Browse Books Site Directory Site Language: English Change Language English Change Language. United States of America engine parts, complete cylinder Belize Bolivia Botswana Brazil assemblies for agricultural and Rica Czech Republic Dominican RPP are warranted to be free from defects Honduras India Iraq Ireland under normal service and operating conditions for a period of one year from the date of installation without limitation on miles or hours of Tanzania United Republic Trinidad and Tobago Turkey Uganda. Kobelco YM912U0001F3 Parts Manual Privacy Policy.Fresenius Medical Care, the triangle logo, Fresenius Renal. These Diagnostic Trouble Codes. New Kawasaki Wheel Loader crawler excavator KOBELCO SK200-V. Fresenius H Machine. Fresenius H Dialysis Machine Manual from cloud storage. Fresenius H Dialysis Machine Manual download. New and remanufactured internal Front End Loader 4WD heads and long block assemblies for agricultural and industrial applications supplied by Tractors Only Sale Price: be free from defects Eternal MM1 FIRST EVERY PANINI Mickey Mantle Card operating conditions for a from the date of. If you do your. Category Shop Fresenius H Dialysis Machine Manual Manual SVC. Kobelco YM912U0001F3 Parts Manual own repairs, you need 2001 2002 Repair Manual. Fresenius 2008H Hemodialysis. If you are winsome corroborating the ebook Fresenius h dialysis machine manual in pdf coming, One Fresenius H Dialysis machine.

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Sign Up Join MedWrench OK name type Receive Summary Emails. FORUMS View All (3) Ask a New Question 0 Replies -Shoaib626 7 months ago 7 months ago Service Card Hi. Have you service card of fresenius 5008 haemodialysis machine. Reply 1 Reply -ALEPH GROUP INC 2 years ago 2 years ago Dimenensions We are creating a mobile dialysis unit and we need dimensions for these units (requested by the client) so that we may be able to fit 8 units in a 50 ft. unit. Reply 2 Replies -Marc Kidney Tech 4 years ago 4 years ago Adding equipment to list Setting up a Haemodialysis Mac. FEATURES Optimal therapy for your patients: By continuing to browse the site you are agreeing to our use of cookies. Please review our Privacy Policy for more details. All Rights Reserved. We specialize in Invivo MRI monitors, Slush Machines, Autoclaves, ESUs, Infusion Pumps, Hypothermia units, and much more.Sign up now. The Fresenius 2008T Dialysis Machine is the most advanced Hemodialysis Machine in the world. Fresenius Medical Care's commitment to continuous improvement and development of new dialysis. Machine in Dialysis. Dialysis Mode. 2017 Kia Spectra Factory Service Manual. Page 3 Fresenius 2008K. The following is a list of new or updated dialysis documents. To view pdf files, you need to July 2018 508033 Revision K 12-FRT-006 Revision B 450347 Revision N 480097 Revision E 480097-01 Revision C 480097-02 Revision C June 2018 508635 Revision B 490139 Revision F 05-FRS-001 Revision C May 2018 480099 Revision C 480099-01 Revision B 480099-02 Revision B 508032 Revision F March 2018 490049 Revision F February 2018 490122 Revision O 490122-01 Revision E 490122-02, Revision E 490180 Revision F 490180-01 Revision D 490180-02 Revision C December 2017 508138 Revision J 507665 Revision I 507297 Revision L 507781 Revision H. Select from the links below to access available Operator’s Manuals for your particular machine type.

Select from the links below to access available Operator’s Manuals for your particular machine type. Select from the links below to access available Technical Manuals for your particular machine type. Select from the tabs below to access available Field Service Bulletins for your particular machine type. Bmw E12 Service Manual on this page. The dedicated members of our spare parts Customer Service team are available to handle all your equipment spare parts needs Monday through Friday. Representatives are online, ready to process orders, check order status, verify pricing, issue call tags, and Return Goods Authorization (RGAs). Bilingual assistance is also available for our Spanish-speaking customers. Caution: Federal (US) law restricts these devices to sale by or on the order of a physician. Note: Read the Instructions for Use for safe and proper use of these devices. Or its affiliated companies. All other trademarks are the property of their respective owners.

fresenius cats autotransfusion system manual

Infusion Therapy and Transfusion Medicine 2000;27:307-310. 12. Rosolski T, Matthey T, Frick U, Hachenberg T. Blood separation with two different autotransfusion devices: effects on blood cell quality and coagulation variables. Intraoperative autotransfusion in small children: An in vitro investigation to study its feasability. Perioperative blood salvage during surgical correction of craniosynostosis in infants.Ultrafast processing Easy and safe set up The easy, safe set up and automatic functions guarantee fast and safe handling, even in critical situations. Consistently high haematocrit blood collection reservoir Fully automatic procedure for separating patient blood into packed red cells, platelet rich plasma and platelet poor plasma. The emergency wash. Prices are indicative only and may vary by country, with changes to the cost of raw materials and exchange rates. Terumo technologies and you. For availability of Terumo products in other regions, please contact the Terumo Sales Office nearest you. For product availability in your region, contact the Terumo Sales Office nearest you. Platelet Gel Books Platelet Gel Articles Platelet Gel Forums Platelet Gel Devices Stem Cell Applications Blood Management New Articles Blood-Related Forums Blood Management Terms Blood Management Jobs Sanibel Symposium Store Products Contact These units are pre-owned and in excellent condition. Please contact us for pricing information. The Fresenius Continuous AutoTransfusion System is also effective in trauma applications. Abstract: Use of autotransfusion systems to collect, wash, and concentrate shed blood during surgical procedures is a widely used method for reducing postoperative anemia and the need for blood transfusions. Final packed red cell product was analyzed for red blood cell (RBC), white blood cell, and platelet counts; hemoglobin; hemolysis; RBC recovery rates; and elimination of albumin, total protein, and potassium.

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Sign in Forgot Password. My Bench Close Sign In Not A Member. Sign Up Join MedWrench OK name type Receive Summary Emails. The Fresenius Continuous AutoTransfusion System is also effective in trauma applications. The functional principle of the Fresenius C.A.T.S continuous-action washing chamber ensures high quality of the packed red cells with high hematocrit levels. FORUMS View All (7) Ask a New Question 0 Replies -Costiug 2 months ago 2 months ago Necessity I need Operating (user) Manual and from Service Manual the maintenance Check Sheet to know what is necesary to check to this kind of device.Please help my,thankyou. Reply 0 Replies -Riz 9 months ago 9 months ago Need Service Manual i need service manual for Fresenisu C.A.T.S. Problem is that it is not switching ON. Need circuit Diagram of Power Supply. Does anyone Have the Service Manual for either model of unit so I can determine what all the pm entails. I appreciate that or if you know where to find it on their technical help site?By continuing to browse the site you are agreeing to our use of cookies. Please review our Privacy Policy for more details. All Rights Reserved. The International Journal of Artificial Organs 1996;19:431-434. 3. Brooker RF, Brown WR, Moody DM, Hammon Jr JW, Reboussin DM, Deal DD, Ghazi-Birry HS, Stump DA. Cardiotomy suction: A major source of brain lipid emboli during cardiopulmonary bypass. The Annals of Thoracic Surgery 1998;65:1651-1655. 4. Kincaid EH, Jones TJ, Stump DA, Brown WR, Moody DM, Deal DD, Hammon Jr JW. Processing scavenged blood with a cell saver reduces cerebral lipid microembolization. The Annals of Thoracic Surgery 2000;70:1296-1300. 5. Djaiani G, Fedorko L, Borger MA, Green R, Carroll J, Marcon M, Karski J. Continuous-flow cell saver reduces cognitive decline in elderly patients after coronary bypass surgery. Vascular and Endovascular Surgery 2008;42:32-39. 10. Schulman G. Quality of processed blood for autotransfusion.

S plus device: a low-volume wash, a smart wash, which is similar to the high-quality wash of the C.A.T.S plus device, and an emergency wash. To improve functionality of the device, the overall footprint is smaller and has a height-adjustable centrifuge body. User-friendly options have also been added including a touch screen interface and an auto start processing feature. Secondary objectives included the evaluation of washing and concentrating of RBC to produce a product within certain parameters. They are consistent with the design specifications of the device and user requirements defined during product development. The study was granted an Institutional Review Board exemption and was conducted in a laboratory without any patient contact or collection of protected health information. ABO-compatible whole blood was pooled together and then diluted to an HCT of approximately 20% with isotonic saline to mimic shed blood that is routinely collected intra- or post-operatively. To characterize the final PRC product, laboratory measurements were taken before and after processing the shed blood on each system. Additional testing was conducted at hours 6 and 24 to measure hemolysis during storage. Spun HCTs were tested using manual methods. Complete blood counts were conducted using the KX-2ln Hematology Analyzer (Sysmex, Lincolnshire, IL) at Duke University and Fresenius Kabi, and the XN Hematology Analyzer (Sysmex) at Maine Medical Center. Clinical chemistry testing was centralized using the AU400e (Olympus, Tokyo, Japan). The data from previous validation studies performed showed a mean HCT of 56.8% for the CATSmart system and a mean HCT of 57.0% for the C.A.T.S plus system, with a maximum SD of 7.1. The one-sided 95% chi-squared confidence limit on this SD is 13.6. On the basis of these data, a minimum of 24 sample pairs were needed to provide sufficient power to find the CATSmart system non-inferior to the C.A.T.S plus system at a margin of 15%.

Several methods of blood conservation have been established in an effort to reduce or avoid transfusion of allogenic blood during these procedures. Autotransfusion, also known as cell salvage, is one of those methods and involves recycling the patients shed blood from the surgical field ( 3 ). The blood is anticoagulated, collected into a reservoir, washed, and concentrated into a transfusable packed red cell (PRC) unit. Cell salvage has become a valuable resource in the operating arena as it may minimize or eliminate the need for allogeneic blood transfusion and its associated risks ( 4 ). First-generation cell salvage systems use a Latham bowl for centrifugation of shed blood and operate discontinuously. The Food and Drug Administration (FDA) cleared the first Continuous Autotransfusion System (CATS) (Fresenius Kabi, Lake Zurich, IL) in 1996. This type of device is used during surgical procedures in which shed whole blood is collected from the surgical field, anticoagulated, and collected in a sterile reservoir. This blood is concentrated and washed into a PRC unit for reinfusion. Reported advantages of the CATS continuous system over discontinuous Latham bowl-type systems include the ability to remove lipids from the shed blood and the ability to obtain a consistently higher concentrated PRC product ( 5 ). During the washing process, shed blood is suspended with isotonic saline in the centrifuge and contaminants, along with fat, albumin, and plasma, are removed into a waste bag. It is currently in use today and is the comparison device for their newest device in the product line—CATSmart system. The CATSmart system uses a higher resolution camera that monitors the red blood cell (RBC)-plasma interface and automatically adjusts blood and saline flow rates into the device, which optimizes product separation and washing. It also has the capacity to monitor shed blood and PRC HCT through an in-line sensor. There are three wash options similar to the C.A.T.

The RBC recovery rate and washing efficiency may be influenced by the type of centrifugal device used, rate of blood processing, or the volume of blood available for processing. Shulman examined the efficiency of RBC recovery rates and plasma washout rates of three different cell saver devices using various flow and wash rate protocols. He reported that continuous flow devices had superior performance in terms of processed blood HCT levels and plasma albumin elimination when compared to discontinuous flow devices ( 2 ). The aim of this study was to determine if the CATSmart system was non-inferior to the C.A.T.S plus system. We examined the HCT of the processed blood, the RBC recovery rate, the elimination of total protein and albumin, and RBC viability as measured by hemolysis. The performance was tested when three different processing programs were used on small and large aliquots of shed blood. All objectives, primary and secondary, were met. The paired procedures conducted for evaluation of the CATSmart, as well as C.A.T.S plus systems demonstrated reliable operation and function of RBC recovery, concentration, and washing. The evaluations used the lower end of acceptable blood volume for operation and expected use of the device. The RBC recovery and concentration functions were measured by final HCT of PRC product. A mean RBC recovery rate of 85.4% and a mean HCT of 59.6% were identified across all wash programs evaluated. Of all wash programs evaluated, the smart wash revealed the highest RBC recovery rate of 91.1% and mean HCT of 63.9%. Conversely, the wash with the lowest mean rate of RBC recovery and HCT was the low-volume wash (200 mL) with 71.0% and 55.8%, respectively. Under this wash program, two procedures resulted in HCT 50%. The results demonstrate an efficient elimination of plasma constituents and soluble contaminants with all washes.

A total of 27 sample pairs were used for an equal distribution among wash programs. Furthermore, to evaluate the performance of the device and quality of product when minimal shed blood is processed, nine sample pairs were added to evaluate the 200-mL low-volume wash program. This brought the total number of needed paired tests to 36 for the study. Standard summary statistics ( N, mean, SD, median, minimum, and maximum) are reported for all measures. Non-inferiority testing was carried out evaluating the new sample against a 15% decrease in the primary outcome, spun HCT using a t test only. RESULTS Thirty-eight paired tests were attempted on the CATSmart and C.A.T.S plus systems at three separate centers (Fresenius Kabi, Duke University Hospital, and Maine Medical Center Research Institute) between October 14, 2015 and January 15, 2016. One pair was not evaluable after a PRC sensor error, meaning 37 paired tests were processed completely and available for review. The one non-evaluable procedure occurred on the CATSmart device due to an instrument failure, caused by a PRC failure alarm. This was likely due to a misaligned label on the disposable, which is a known issue and has been corrected. Hemolysis values are found in Table 5. Low-Volume Wash Ten paired tests were evaluated using a starting volume of 200 mL and an HCT of 20%. Nine paired tests were evaluated using a starting volume of 700 mL and an HCT of 20%. Smart Wash Nine paired tests were evaluated using a starting volume of 1,000 mL and an HCT of 20%. Emergency Wash Nine paired tests were evaluated using a starting volume of 1,000 mL and an HCT of 20%. DISCUSSION The salvage of shed blood during surgical procedures has been recognized as an important component to hospital blood conservation programs ( 7 ). However, it has been well recognized that the quality of processed salvaged blood is quite variable ( 2, 5 ).

SFinal packed red cell product was analyzed for red blood cell (RBC), white blood cell, and platelet counts; hemoglobin; hemolysis; RBC recovery rates; and elimination of albumin, total protein, and potassium. The mean hematocrit (HCT) after processing with CATSmart and C.A.T.SSe veral methods of blood conserv ation have been establis hed in an effort to reduce or avoid tr ansfusion of allogenic blood during these procedures. Autotransfusion, also known as cell salvage, is one of those methods and involves re cycling the patien ts shed blood from the surgical field (3). The blood is anti coagulated, collec ted into a reservoir, washed, and concentrated into a transfusable packed red cell (PRC) unit. Cell salvage has become a valuable re source in the operatin g arena as it may minim ize or eliminate th e need for allogenei c blood transfusion and its associat ed risks (4). First-gen eration cell salvage syst ems use a Latham bowl for centrifugation of shed blood and operate discontinu- ously. The Food and Drug Admini stration (FDA) cleare d the.This type of device is used during surgical procedures in which shed whole blood is collected from the surgical.This blood is concentrat ed and washed into a PRC unit for reinfusi on. Reported adva ntages of the CA TS continuous syst em over discontinuous Latham bowl-type systems include the ability to remove lipids from the shed blood and the ability to obtain a consistently higher concentrated PRC product (5). During the wash ing process, shed bl ood is suspended with Received for publication June 24, 2016; accepted October 18, 2016. Address correspondence to: Edmund H. Jooste, MBChB, Division of Pediatric Anesthesiolog y, Department of Anesthesiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710. They developed methods, conducted training, and tested chemistry. 107 The washed blood is concentrated to a.

It is currently in use today and is the comparison device for their newest device in the product line — CA TSmart system. The CA TSmart system uses a higher resolution camera that monitors th e red blood cell (RBC)-plasma in terface and automati cally adjusts blood an d saline.It also has the capacity to monitor shed blood and PRC HCT thro ugh an in-line sensor. There are thre e wash options similar to the C.A.T.S plus device: a low- volume wash, a smart wash, which is si milar to the high- quality wash of the C. A.T.S plus device, and an emer gency wash. T o improve functi onality of the device, the overa ll footprint is sm aller and has a height-adju stable centrifuge body. User-friendly op tions have also been added in cluding a touch screen inte rface and an auto start proce ssing feature. The primary objective of this study was to evaluate whether the CA TSmart system is non-inferior to the C.A.T.S plus system, in bein g able to produce a mean PRC HCT within a 15% ma rgin of the C.A.T.S plus system and whether the. Secondary ob jectives included the eval uation of washing and concen trating of RBC to produ ce a product within certain par ameters. The se secondary objectiv e parameters are based on the perfo rmance of the predic ate device using stu dies associated with the 510K application for the CATS and C.A.T.S plus devices. They are consistent with the design speci.The FDA requi res manufac- turers of RBC produ cts to demonstrate ysis at the end of storage as part of the product approval pro- cess. This is also a measure of cell viability at the end of storage. The study was granted an Institutio nal Review Board exempti on and was conducted in a laborator y without any patie nt contact or collect ion of protected heal th information. ABO-co mpatible whole blood was poole d together and then di luted to an HCT of approximate ly 20% with isotonic saline to mi mic shed blood that is routi nely collected intra- or post -operatively. T o charac- terize the.

This is important in the operating room, as irrigation fluids, anticoagulant, and other chemicals or debris may be aspirated into the reservoir during surgery. The device removes such contaminants based on density. As the centrifuge spins, soluble blood components are separated from formed cellular bodies (RBC, WBC, PLTs) and removed ( 9 ). Overall potassium, PLT and WBC elimination data were also obtained and found to be 92.1%, 78.0%, and 34.7%, respectively. The WBC elimination was determined to be 34.7% and under special conditions in which it would be clinically advantageous to leuko reduce the RBC product, a leukocyte reducing filter may be used. RBC washing functionality with the CATSmart system was measured by elimination of plasma constituents. Total protein and albumin elimination rates were excellent and measured 97.1% and 97.6%, respectively. The smart wash, as expected, demonstrated the highest elimination rates of protein and albumin of 98.9% and 99.1%, respectively, whereas the emergency wash had a slightly lower elimination rate of total protein and albumin of 94.4% and 95.1%, respectively. This finding is important as the product from an emergency wash is still excellent, while the processing time is far less than that of the smart wash, 9.3 minutes to 16 minutes, respectively. Viability of the RBC collected over time is also important. Overall, very low levels of hemolysis were identified immediately after processing (.07%), at 6 hours (.06%), and at 24 hours (.06%). Maximum reported hemolysis was.27%, which met the secondary objective of 10 ). Therefore, to assess product acceptability for both intra- and post-operative conditions, hemolysis at those specific time points was assessed. There are a number of improved functionalities in the CATSmart. It has a quieter motor, the height-adjustable body and overall smaller footprint allows the CATSmart device to better fit in smaller spaces and is ergonomically friendly.

The touch screen display, which can be used with gloved hands, has a quick start option which is helpful when rapid processing of shed blood is necessary. In addition, the autostart processing feature allows the operator to focus on the patient, not the device, generating a safety benefit with the device. Regardless of the wash program used, cells are efficiently recovered, washed, and concentrated, and produce a quality PRC product that is appropriate for autologous transfusion. The study also confirmed the CATSmart system is non-inferior to the C.A.T.S plus system in mean PRC HCT within a 15% margin. All secondary objectives—RBC recovery rate, plasma and total protein elimination, and hemolysis after 24 hours—were also achieved. This study demonstrated that the CATSmart and C.A.T.S plus systems produce a high-quality PRC product, even when volumes as small as 200 mL are processed using the low-volume wash program. Overall, the enhancements to the CATSmart system, along with the study results, make it a viable addition to any institution using blood conservation and cell salvage.Shulman G.Ferraris V. A., Ferraris S. P., Saha S. P., et al.. Keeling M. M., Gray L. A. Jr, Brink M. A., Hillerich V. K., Bland K. I. Serrick C. J., Scholz M., Melo A., Singh O., Noel D. Booke M., Fobker M., Fingerhut D., Storm M., Mortlemans Y., Van Aken H. Ferraris V. A., Brown J., Despotis G., et al.. Seyfried T., Breu A., Gruber M., Reipert J., Hansen E. Gruber M., Breu A., Frauendorf M., Seyfried T., Hansen E. American Association of Blood Banks. The aim of this study was to evaluate the CATSmart Continuous Autotransfusion System wash program performance with small (200 or 700 mL) and large volumes (1,000 mL) of shed blood and to determine non-inferiority of the CATSmart to the C.A.T.

Add itional testing was conduc ted at hours 6 and 24 to measure hemoly sis during storage. Spun HCT s were tested using manual met hods. Complete blood counts were conducted using the KX- 2ln Hematology Analyzer (Sysmex, Lincolnshire, IL) at Duke University and Fresenius Kabi, and the XN Hematology Analyzer (Sysmex) at Maine Medical Center. The data from previous validation studies performed showed a mean HCT of 56.8% for the CA TSmart system and a mean HCT of 57.0% for the C.A. T.S plus system, with a maximum SD of 7.1. The on e-sided 95% chi- squared con.A total of 27 sample pairs were us ed for an equal distribu- tion among wash progr ams. Furthermore, to eval uate the performanc e of the device and qualit y of product when minimal shed blo od is processed, nine sample pa irs were added to eval uate the 200-mL low-v olume wash program. This brought the to tal number of needed paired test s to 36 for the study. Non-infer iority testing was carr ied out evaluating th e new sample agai nst a 15% decrease in the p rimary outcome, spun HCT using a t test only.One pair was not evaluable after a PRC sensor error, meaning 37 paired tests were processed completely and available for review. The one non-evaluable procedure occurred on the CA TSmart device due to an instrument failure, caused by a PRC failure alarm. This was likely due to a misaligned label on the disposable, which is a known issue and ha s been corrected. Table 2 demon- strates the no n-inferiority of th e CATS mart system at 15% margin whe n compared to the C.A. T.S plus system with ar e s u l t i n g p value lts in Tables 3 an d 4, all washes ar e evaluated on the seco ndary ef.Hemolysis values are found in Table 5. Differences in secondary outcomes between the two systems show ed generally small clinical ly irrelevant, but statistica lly signi. Nine paired te sts were evaluated us ing a starting volume of 700 mL an d an HCT of 20 %.

Smart Wash Nine paired te sts were evaluated u sing a starting volume of 1,000 mL and an HCT of 20 %.DISCUSSION The salvage of shed blood during surgical procedures has been recognized as an important component to hospital blood conservation programs (7). However, it has been well recognized that the quality of processed salvaged blood is quite vari able (2,5). The RBC recovery rate and washing ef.Shulman examined the ef.He reported that continu- ous.The perfor- mance was tested when three different processing programs were used on small and large aliquots of shed blood. The paired procedures conducted for evaluation of the CA TSmart, as well as C.A.T.S plus systems demonstrated reliable operation and function of RBC recovery, concen- tration, and washing. The RBC recovery and concentration functions were measured by.A mean RBC recovery rate of 85.4% and a mean HCT of 59.6% were identi ? ed across all wash programs evaluated. Of all wash programs evaluated, the smart wash revealed the highest RBC recovery rate of 91.1% and mean HCT of 63.9%. Conversely, the wash with the lowest mean rate of RBC recovery and HCT was the low-volume wash (200 mL) with 71.0% and 55.8%, respectively. Under this wash program, two procedures resulted in HCT low-volume wash (200 mL) with 20% HCT represents 40 mL of RBCs, which app roaches the minimal RBC volu me the device can ef.The results demonstrate an ef.This is important in the operating room, as irriga- tion.As the centrifuge spins, soluble blood components are sepa- rated from form ed cellular bodies (RBC, WB C, PLT s) and removed ( 9). Over all potassi um, PLT and WBC elimination data were also obtained and found to be 92.1%, 78.0%, and 34.7%, resp ectively. The WBC elimination was dete r- mined to be 34.7 % and under special cond itions in which it would be clin ically advantage ous to leuko reduce th e RBC product, a leu kocyte reducing.T otal protein and al bumin elimination ra tes were excellent and measured 97.1 % and 97.

6%, respec tively. Th e smart wash, as expected, de monstrated the highest el imination rates of protein and al bumin of 98.9% and 99.1 %, respectively, whereas the emer gency wash had a slightly lo wer elimina- tion rate of total protein and albumin of 94.4% and 95.1%, respectively. This ? nding is important as the product from an emergency wash is still excellent, while the processing time is far less than that of the smart wash, 9.3 minutes to 16 minutes, respectively. Viability of the RBC collected over time is also impor- tant. Overall, very low levels of hemolysis were identi.Hemolysis testin g was conducted at ho urs 6 and 24 because the dev ice can be used for both intra- and post-operative shed blood collections. Post-operativ e shed blood can be stored for up to 6 h ours after processin g (10). Therefore, to assess product acceptability for both intra- and post- operative conditions, hemolysis at those speci.There are a number of improved functionalities in the CA TSmart. It has a quieter motor, the height-adjustable body and overall smaller footprint allows the CA TSmart device to better.The touch scre en display, which can be used with gloved hands, has a quick start option which is help ful when rapid proce ssing of shed blood is neces sary. In addi - tion, the autost art processing feat ure allows the operator to focus on the p atient, not the device, generating a safety bene.Regardless of the wash program used, cells are ef.The study also con.All secondary objectives — RBC recovery rate, plasma and to tal protein elimin ation, and hemolys is after 24 hours — were al so achieved. This study demo nstrated that the CA TSmart and C.A.T.S plus systems produ ce a high-qual ity PRC product, even when volume s as small as 200 mL are processed using th e low-volume wash program. Overall, the enhancements to the CA TSmart system, along with the study results, make it a viable addition to any insti- tution using blood conser vation and cell salvage. REFERENCES 1.

Moskowitz DM, Klein JJ, Shander A, et al. Predictors of transfusion requirements for cardiac surgical procedures at a blood conservation center. Perioperative blood transfu- sion and blood conservation in cardiac surgery: The Society of Tho- racic Surgeons and the Society of Cardiovascular Anesthesiologists clinical practice guideline. Intraoperative autotransfusion. Standards for Perioperative Autologous Blood Collection and Administration, 6th ed.; Bethesda, MD: AABB.The use of cell salvage and autologous blood transfusion has become an important method of blood conservation. So far, there are no clinical data about the performance of the continuous autotransfusion device CATSmart. Methods. In total, 74 patients undergoing either cardiac or orthopedic surgery were included in this prospective, bicenter and observational technical evaluation to validate red cell separation process and washout quality of CATSmart. Results. Conclusion. The new autotransfusion device enables sufficient red cell separation and washout quality. State of art. Review Article Jan 2019 A.Yu. Lubnin V.V. Gromova View Comparison of three autotransfusion devices for utilization in the pediatric population Article May 2020 Perfusion Richard Melchior Molly Dreher Brandon Shade Tami Rosenthal Introduction. A device that may help attenuate the amount of homologous blood product given to pediatric cardiac surgical patients is the autotransfusion device. Three separate autotransfusion devices were selected for evaluation. Each of the autotransfusion devices were used to collect salvageable blood from the surgical field as well as to process residual blood from the cardiopulmonary bypass circuit after decannulation. The cell salvage process was performed in accordance with the manufacturer’s instructions for use and the recommended settings for processing and washing.

The Sorin Xtra device had the 55 mL bowl set up for all cases, while the Fresenius continuous autotransfusion systems utilized the standard disposable for each device. The Continuous Autotransfusion System Smart tended to produce the highest hematocrit product, ranging from 44 to 81%. Discussion. Through this evaluation, it was determined the continuous autotransfusion systems provided the highest hematocrit with the lowest recovered packed red cell volume, while the Sorin Xtra packed red cell product showed to have a lower hematocrit with a larger packed red cell volume. Each device proved effective within our pediatric population. View Show abstract Blood clot formation in reinfusion bag with CATSmart: Two case reports Article Jun 2019 INT J ARTIF ORGANS Jun Hyun Kim Ja Young Bae Sang Il Lee Ji Yeon Kim Autologous blood cell salvage reduces the need for postoperative allogeneic blood transfusion and alleviates immunologic reactions, so the technique is commonly used in cardiac surgery. The continuous autotransfusion system is a type of blood cell salvage device. Although the processing program of continuous autotransfusion system includes filtering of several materials from suctioned blood, such as clots, leukocytes, cytokines, and complement, we identified some unexpected blood clots in the reinfusion bag. Pathologic examination revealed that the clots were composed of fibrin, red blood cell aggregates, and histiocytes. We report two cases of these abnormal findings during the use of CATSmart in cardiac surgery. View Show abstract 2011 Update to The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Blood Conservation Clinical Practice Guidelines Article Full-text available Mar 2011 Vic Ferraris Jeremiah R Brown George Despotis Kenneth G Shann Practice guidelines reflect published literature. Because of the ever changing literature base, it is necessary to update and revise guideline recommendations from time to time.

fresenius cats user manual

Infusion Therapy and Transfusion Medicine 2000;27:307-310. 12. Rosolski T, Matthey T, Frick U, Hachenberg T. Blood separation with two different autotransfusion devices: effects on blood cell quality and coagulation variables. Intraoperative autotransfusion in small children: An in vitro investigation to study its feasability. Perioperative blood salvage during surgical correction of craniosynostosis in infants.Ultrafast processing Easy and safe set up The easy, safe set up and automatic functions guarantee fast and safe handling, even in critical situations. Consistently high haematocrit blood collection reservoir Fully automatic procedure for separating patient blood into packed red cells, platelet rich plasma and platelet poor plasma. The emergency wash. Prices are indicative only and may vary by country, with changes to the cost of raw materials and exchange rates. Terumo technologies and you. For availability of Terumo products in other regions, please contact the Terumo Sales Office nearest you. For product availability in your region, contact the Terumo Sales Office nearest you. Platelet Gel Books Platelet Gel Articles Platelet Gel Forums Platelet Gel Devices Stem Cell Applications Blood Management New Articles Blood-Related Forums Blood Management Terms Blood Management Jobs Sanibel Symposium Store Products Contact These units are pre-owned and in excellent condition. Please contact us for pricing information. The Fresenius Continuous AutoTransfusion System is also effective in trauma applications. It is possible that some links will connect you to content onlyIn the case of any discrepancy in meaning, the English version is considered official. Thank. The aim of this study was to evaluate the CATSmart Continuous Autotransfusion System wash program performance with small (200 or 700 mL) and large volumes (1,000 mL) of shed blood and to determine non-inferiority of the CATSmart to the C.A.T.

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Sign in Forgot Password. My Bench Close Sign In Not A Member. Sign Up Join MedWrench OK name type Receive Summary Emails. The Fresenius Continuous AutoTransfusion System is also effective in trauma applications. The functional principle of the Fresenius C.A.T.S continuous-action washing chamber ensures high quality of the packed red cells with high hematocrit levels. FORUMS View All (7) Ask a New Question 0 Replies -Costiug 2 months ago 2 months ago Necessity I need Operating (user) Manual and from Service Manual the maintenance Check Sheet to know what is necesary to check to this kind of device.Please help my,thankyou. Reply 0 Replies -Riz 9 months ago 9 months ago Need Service Manual i need service manual for Fresenisu C.A.T.S. Problem is that it is not switching ON. Need circuit Diagram of Power Supply. Does anyone Have the Service Manual for either model of unit so I can determine what all the pm entails. I appreciate that or if you know where to find it on their technical help site?By continuing to browse the site you are agreeing to our use of cookies. Please review our Privacy Policy for more details. All Rights Reserved. The International Journal of Artificial Organs 1996;19:431-434. 3. Brooker RF, Brown WR, Moody DM, Hammon Jr JW, Reboussin DM, Deal DD, Ghazi-Birry HS, Stump DA. Cardiotomy suction: A major source of brain lipid emboli during cardiopulmonary bypass. The Annals of Thoracic Surgery 1998;65:1651-1655. 4. Kincaid EH, Jones TJ, Stump DA, Brown WR, Moody DM, Deal DD, Hammon Jr JW. Processing scavenged blood with a cell saver reduces cerebral lipid microembolization. The Annals of Thoracic Surgery 2000;70:1296-1300. 5. Djaiani G, Fedorko L, Borger MA, Green R, Carroll J, Marcon M, Karski J. Continuous-flow cell saver reduces cognitive decline in elderly patients after coronary bypass surgery. Vascular and Endovascular Surgery 2008;42:32-39. 10. Schulman G. Quality of processed blood for autotransfusion.

It is currently in use today and is the comparison device for their newest device in the product line — CA TSmart system. The CA TSmart system uses a higher resolution camera that monitors th e red blood cell (RBC)-plasma in terface and automati cally adjusts blood an d saline.It also has the capacity to monitor shed blood and PRC HCT thro ugh an in-line sensor. There are thre e wash options similar to the C.A.T.S plus device: a low- volume wash, a smart wash, which is si milar to the high- quality wash of the C. A.T.S plus device, and an emer gency wash. T o improve functi onality of the device, the overa ll footprint is sm aller and has a height-adju stable centrifuge body. User-friendly op tions have also been added in cluding a touch screen inte rface and an auto start proce ssing feature. The primary objective of this study was to evaluate whether the CA TSmart system is non-inferior to the C.A.T.S plus system, in bein g able to produce a mean PRC HCT within a 15% ma rgin of the C.A.T.S plus system and whether the. Secondary ob jectives included the eval uation of washing and concen trating of RBC to produ ce a product within certain par ameters. The se secondary objectiv e parameters are based on the perfo rmance of the predic ate device using stu dies associated with the 510K application for the CATS and C.A.T.S plus devices. They are consistent with the design speci.The FDA requi res manufac- turers of RBC produ cts to demonstrate ysis at the end of storage as part of the product approval pro- cess. This is also a measure of cell viability at the end of storage. The study was granted an Institutio nal Review Board exempti on and was conducted in a laborator y without any patie nt contact or collect ion of protected heal th information. ABO-co mpatible whole blood was poole d together and then di luted to an HCT of approximate ly 20% with isotonic saline to mi mic shed blood that is routi nely collected intra- or post -operatively. T o charac- terize the.

SFinal packed red cell product was analyzed for red blood cell (RBC), white blood cell, and platelet counts; hemoglobin; hemolysis; RBC recovery rates; and elimination of albumin, total protein, and potassium. The mean hematocrit (HCT) after processing with CATSmart and C.A.T.SSe veral methods of blood conserv ation have been establis hed in an effort to reduce or avoid tr ansfusion of allogenic blood during these procedures. Autotransfusion, also known as cell salvage, is one of those methods and involves re cycling the patien ts shed blood from the surgical field (3). The blood is anti coagulated, collec ted into a reservoir, washed, and concentrated into a transfusable packed red cell (PRC) unit. Cell salvage has become a valuable re source in the operatin g arena as it may minim ize or eliminate th e need for allogenei c blood transfusion and its associat ed risks (4). First-gen eration cell salvage syst ems use a Latham bowl for centrifugation of shed blood and operate discontinu- ously. The Food and Drug Admini stration (FDA) cleare d the.This type of device is used during surgical procedures in which shed whole blood is collected from the surgical.This blood is concentrat ed and washed into a PRC unit for reinfusi on. Reported adva ntages of the CA TS continuous syst em over discontinuous Latham bowl-type systems include the ability to remove lipids from the shed blood and the ability to obtain a consistently higher concentrated PRC product (5). During the wash ing process, shed bl ood is suspended with Received for publication June 24, 2016; accepted October 18, 2016. Address correspondence to: Edmund H. Jooste, MBChB, Division of Pediatric Anesthesiolog y, Department of Anesthesiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710. They developed methods, conducted training, and tested chemistry. 107 The washed blood is concentrated to a.

Differences in secondary outcomes between the two systems show ed generally small clinical ly irrelevant, but statistica lly signi. Nine paired te sts were evaluated us ing a starting volume of 700 mL an d an HCT of 20 %. Smart Wash Nine paired te sts were evaluated u sing a starting volume of 1,000 mL and an HCT of 20 %.DISCUSSION The salvage of shed blood during surgical procedures has been recognized as an important component to hospital blood conservation programs (7). However, it has been well recognized that the quality of processed salvaged blood is quite vari able (2,5). The RBC recovery rate and washing ef.Shulman examined the ef.He reported that continu- ous.The perfor- mance was tested when three different processing programs were used on small and large aliquots of shed blood. All objectives, primary and secondary, were met. The paired procedures conducted for evaluation of the CA TSmart, as well as C.A.T.S plus systems demonstrated reliable operation and function of RBC recovery, concen- tration, and washing. The evaluations used the lower end of acceptable blood volume for operation and expected use of the device. The RBC recovery and concentration functions were measured by.A mean RBC recovery rate of 85.4% and a mean HCT of 59.6% were identi ? ed across all wash programs evaluated. Of all wash programs evaluated, the smart wash revealed the highest RBC recovery rate of 91.1% and mean HCT of 63.9%. Conversely, the wash with the lowest mean rate of RBC recovery and HCT was the low-volume wash (200 mL) with 71.0% and 55.8%, respectively. Under this wash program, two procedures resulted in HCT low-volume wash (200 mL) with 20% HCT represents 40 mL of RBCs, which app roaches the minimal RBC volu me the device can ef.The results demonstrate an ef.This is important in the operating room, as irriga- tion.As the centrifuge spins, soluble blood components are sepa- rated from form ed cellular bodies (RBC, WB C, PLT s) and removed ( 9).

Add itional testing was conduc ted at hours 6 and 24 to measure hemoly sis during storage. Spun HCT s were tested using manual met hods. Complete blood counts were conducted using the KX- 2ln Hematology Analyzer (Sysmex, Lincolnshire, IL) at Duke University and Fresenius Kabi, and the XN Hematology Analyzer (Sysmex) at Maine Medical Center. Clinical chemistry testing was centralized using the AU400e (Olympus, Tokyo, Japan). The data from previous validation studies performed showed a mean HCT of 56.8% for the CA TSmart system and a mean HCT of 57.0% for the C.A. T.S plus system, with a maximum SD of 7.1. The on e-sided 95% chi- squared con.A total of 27 sample pairs were us ed for an equal distribu- tion among wash progr ams. Furthermore, to eval uate the performanc e of the device and qualit y of product when minimal shed blo od is processed, nine sample pa irs were added to eval uate the 200-mL low-v olume wash program. This brought the to tal number of needed paired test s to 36 for the study. Standard summary statistics ( N, mean, SD, median, minimum, and maximum) are reported for all measures. Non-infer iority testing was carr ied out evaluating th e new sample agai nst a 15% decrease in the p rimary outcome, spun HCT using a t test only.One pair was not evaluable after a PRC sensor error, meaning 37 paired tests were processed completely and available for review. The one non-evaluable procedure occurred on the CA TSmart device due to an instrument failure, caused by a PRC failure alarm. This was likely due to a misaligned label on the disposable, which is a known issue and ha s been corrected. Table 2 demon- strates the no n-inferiority of th e CATS mart system at 15% margin whe n compared to the C.A. T.S plus system with ar e s u l t i n g p value lts in Tables 3 an d 4, all washes ar e evaluated on the seco ndary ef.Hemolysis values are found in Table 5.

Three separate autotransfusion devices were selected for evaluation. Each of the autotransfusion devices were used to collect salvageable blood from the surgical field as well as to process residual blood from the cardiopulmonary bypass circuit after decannulation. The cell salvage process was performed in accordance with the manufacturer’s instructions for use and the recommended settings for processing and washing. The Sorin Xtra device had the 55 mL bowl set up for all cases, while the Fresenius continuous autotransfusion systems utilized the standard disposable for each device. The Continuous Autotransfusion System Smart tended to produce the highest hematocrit product, ranging from 44 to 81%. Discussion. Through this evaluation, it was determined the continuous autotransfusion systems provided the highest hematocrit with the lowest recovered packed red cell volume, while the Sorin Xtra packed red cell product showed to have a lower hematocrit with a larger packed red cell volume. Each device proved effective within our pediatric population. View Show abstract Blood clot formation in reinfusion bag with CATSmart: Two case reports Article Jun 2019 INT J ARTIF ORGANS Jun Hyun Kim Ja Young Bae Sang Il Lee Ji Yeon Kim Autologous blood cell salvage reduces the need for postoperative allogeneic blood transfusion and alleviates immunologic reactions, so the technique is commonly used in cardiac surgery. The continuous autotransfusion system is a type of blood cell salvage device. Although the processing program of continuous autotransfusion system includes filtering of several materials from suctioned blood, such as clots, leukocytes, cytokines, and complement, we identified some unexpected blood clots in the reinfusion bag. Pathologic examination revealed that the clots were composed of fibrin, red blood cell aggregates, and histiocytes. We report two cases of these abnormal findings during the use of CATSmart in cardiac surgery.

View Show abstract 2011 Update to The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Blood Conservation Clinical Practice Guidelines Article Full-text available Mar 2011 Vic Ferraris Jeremiah R Brown George Despotis Kenneth G Shann Practice guidelines reflect published literature. Because of the ever changing literature base, it is necessary to update and revise guideline recommendations from time to time. The Society of Thoracic Surgeons recommends review and possible update of previously published guidelines at least every three years. This summary is an update of the blood conservation guideline published in 2007. The search methods used in the current version differ compared to the previously published guideline. Literature searches were conducted using standardized MeSH terms from the National Library of Medicine PUBMED database list of search terms. The following terms comprised the standard baseline search terms for all topics and were connected with the logical 'OR' connector--Extracorporeal circulation (MeSH number E04.292), cardiovascular surgical procedures (MeSH number E04.100), and vascular diseases (MeSH number C14.907). Use of these broad search terms allowed specific topics to be added to the search with the logical 'AND' connector.

Over all potassi um, PLT and WBC elimination data were also obtained and found to be 92.1%, 78.0%, and 34.7%, resp ectively. The WBC elimination was dete r- mined to be 34.7 % and under special cond itions in which it would be clin ically advantage ous to leuko reduce th e RBC product, a leu kocyte reducing.T otal protein and al bumin elimination ra tes were excellent and measured 97.1 % and 97.6%, respec tively. Th e smart wash, as expected, de monstrated the highest el imination rates of protein and al bumin of 98.9% and 99.1 %, respectively, whereas the emer gency wash had a slightly lo wer elimina- tion rate of total protein and albumin of 94.4% and 95.1%, respectively. This ? nding is important as the product from an emergency wash is still excellent, while the processing time is far less than that of the smart wash, 9.3 minutes to 16 minutes, respectively. Viability of the RBC collected over time is also impor- tant. Overall, very low levels of hemolysis were identi.Hemolysis testin g was conducted at ho urs 6 and 24 because the dev ice can be used for both intra- and post-operative shed blood collections. Post-operativ e shed blood can be stored for up to 6 h ours after processin g (10). Therefore, to assess product acceptability for both intra- and post- operative conditions, hemolysis at those speci.There are a number of improved functionalities in the CA TSmart. It has a quieter motor, the height-adjustable body and overall smaller footprint allows the CA TSmart device to better.The touch scre en display, which can be used with gloved hands, has a quick start option which is help ful when rapid proce ssing of shed blood is neces sary. In addi - tion, the autost art processing feat ure allows the operator to focus on the p atient, not the device, generating a safety bene.Regardless of the wash program used, cells are ef.The study also con.

All secondary objectives — RBC recovery rate, plasma and to tal protein elimin ation, and hemolys is after 24 hours — were al so achieved. This study demo nstrated that the CA TSmart and C.A.T.S plus systems produ ce a high-qual ity PRC product, even when volume s as small as 200 mL are processed using th e low-volume wash program. Overall, the enhancements to the CA TSmart system, along with the study results, make it a viable addition to any insti- tution using blood conser vation and cell salvage. REFERENCES 1. Moskowitz DM, Klein JJ, Shander A, et al. Predictors of transfusion requirements for cardiac surgical procedures at a blood conservation center. Perioperative blood transfu- sion and blood conservation in cardiac surgery: The Society of Tho- racic Surgeons and the Society of Cardiovascular Anesthesiologists clinical practice guideline. Intraoperative autotransfusion. Standards for Perioperative Autologous Blood Collection and Administration, 6th ed.; Bethesda, MD: AABB.The use of cell salvage and autologous blood transfusion has become an important method of blood conservation. So far, there are no clinical data about the performance of the continuous autotransfusion device CATSmart. Methods. In total, 74 patients undergoing either cardiac or orthopedic surgery were included in this prospective, bicenter and observational technical evaluation to validate red cell separation process and washout quality of CATSmart. Results. Conclusion. The new autotransfusion device enables sufficient red cell separation and washout quality. State of art. Review Article Jan 2019 A.Yu. Lubnin V.V. Gromova View Comparison of three autotransfusion devices for utilization in the pediatric population Article May 2020 Perfusion Richard Melchior Molly Dreher Brandon Shade Tami Rosenthal Introduction. A device that may help attenuate the amount of homologous blood product given to pediatric cardiac surgical patients is the autotransfusion device.

In this 2011 guideline update, areas of major revision include: 1) management of dual anti-platelet therapy before operation, 2) use of drugs that augment red blood cell volume or limit blood loss, 3) use of blood derivatives including fresh frozen plasma, Factor XIII, leukoreduced red blood cells, platelet plasmapheresis, recombinant Factor VII, antithrombin III, and Factor IX concentrates, 4) changes in management of blood salvage, 5) use of minimally invasive procedures to limit perioperative bleeding and blood transfusion, 6) recommendations for blood conservation related to extracorporeal membrane oxygenation and cardiopulmonary perfusion, 7) use of topical hemostatic agents, and 8) new insights into the value of team interventions in blood management. Much has changed since the previously published 2007 STS blood management guidelines and this document contains new and revised recommendations. View Show abstract Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline Article Full-text available Jun 2007 Vic Ferraris Suellen P. Ferraris Sibu Saha Simon C Body A minority of patients having cardiac procedures (15% to 20%) consume more than 80% of the blood products transfused at operation. Blood must be viewed as a scarce resource that carries risks and benefits. A careful review of available evidence can provide guidelines to allocate this valuable resource and improve patient outcomes. We reviewed all available published evidence related to blood conservation during cardiac operations, including randomized controlled trials, published observational information, and case reports. Conventional methods identified the level of evidence available for each of the blood conservation interventions. Review of published reports identified a high-risk profile associated with increased postoperative blood transfusion.

Six variables stand out as important indicators of risk: (1) advanced age, (2) low preoperative red blood cell volume (preoperative anemia or small body size), (3) preoperative antiplatelet or antithrombotic drugs, (4) reoperative or complex procedures, (5) emergency operations, and (6) noncardiac patient comorbidities. Careful review revealed preoperative and perioperative interventions that are likely to reduce bleeding and postoperative blood transfusion. Preoperative interventions that are likely to reduce blood transfusion include identification of high-risk patients who should receive all available preoperative and perioperative blood conservation interventions and limitation of antithrombotic drugs. Perioperative blood conservation interventions include use of antifibrinolytic drugs, selective use of off-pump coronary artery bypass graft surgery, routine use of a cell-saving device, and implementation of appropriate transfusion indications. An important intervention is application of a multimodality blood conservation program that is institution based, accepted by all health care providers, and that involves well thought out transfusion algorithms to guide transfusion decisions. Based on available evidence, institution-specific protocols should screen for high-risk patients, as blood conservation interventions are likely to be most productive for this high-risk subset. View Show abstract Processing of small volumes in blood salvage devices Article Jul 2014 Transfusion Timo Seyfried Anita Breu Michael Andreas Gruber Ernil Hansen Background. New technical developments such as a small Latham bowl, a continuous autotransfusion system, and a dynamic disk designed for postoperative autotransfusion raise hopes for a possible application of blood salvage in young children. However, the minimal blood volume for effective processing under clinically relevant conditions has yet to be determined.Study Design and Methods.

Fresh blood from volunteer donations adjusted to a hematocrit (Hct) of 10% was used to test ELECTA (Sorin) equipped with a 55-mL bowl, C.A.T.S (Fresenius) in the pediatric program mode, and OrthoPAT (Haemonetics). Twenty-milliliter portions of red blood cells (RBCs) were added and processed under various conditions, including clinically relevant first filling and intermittent emptying. RBC recovery and availability and plasma elimination were calculated from the Hct, free hemoglobin, and total protein.ResultsThe main impediment to recovery and availability was the first filling. There, RBC recovery was significantly reduced, while it subsequently varied between 93 and 98%. To produce the first 30 mL of RBCs, ELECTA required 42 mL and C.A.T.S and OrthoPAT 62 mL owing to the dead space of the separation chamber or reservoir, respectively. RBC availability was much higher in subsequent processes, with only minimal differences between the three devices. They all consistently provided high plasma elimination rates.Conclusion. The continuous system showed no advantage over a small Latham bowl. From the results it can be calculated that the limit for feasible cell salvage at present is an infant of 6 months. All three devices are suitable for the processing of small volumes, but have the scope for further optimization. View Show abstract Washing of banked blood by three different blood salvage devices Article Aug 2012 Transfusion Michael Andreas Gruber Anita Breu Melanie Frauendorf Ernil Hansen BACKGROUND: Storage lesions in red blood cells (RBCs) lead to an accumulation of soluble contaminants that can compromise the patient. Organ failures, coagulopathies, and cardiovascular events including lethal cardiac arrest have been reported, especially with massive transfusion or in pediatric patients.

Washing improves the quality of stored RBCs, and autotransfusion devices have been proposed for intraoperative processing, but these devices were designed for diluted wound blood, and limited data on their performance with RBCs are available. STUDY DESIGN AND METHODS: Three autotransfusion devices (Electa, Sorin; CATS, Fresenius; OrthoPAT, Haemonetics) differing in function of their centrifugation chambers were evaluated with RBCs at the end of their shelf life and with dilutions thereof. Elimination rates of potassium, plasma free hemoglobin, total protein, citrate, acid equivalents, and iomeprol added as a marker substance were analyzed, in addition to RBC recoveries. RESULTS: Product hematocrit (Hct) levels ranged between 54.8 and 72.6%. RBC recovery rates were between 62.7 and 95.0%, the lowest being with the OrthoPAT processing of undiluted RBCs. Plasma elimination rates increased with predilution and ranged from 46.6% to 99.5%, the lowest being with the CATS and undiluted RBCs. Washing did not change pH and buffering capacity of RBCs. CONCLUSION: Autotransfusion devices offer a practical and obviously economical option to wash banked RBCs intraoperatively to prevent hyperkalemia and other disturbances in massive transfusion or pediatric patients. Predilution improves elimination rates, especially in devices that produce high product Hct levels. With a Y-tubing the RBCs should bypass reservoir and vacuum, and the procedure should be guarded by a policy and procedure manual and a quality management system. View Show abstract Intraoperative autotransfusion. Experience in 725 consecutive cases Article Jun 1983 ANN SURG MARIE M. KEELING Laman A. Gray MARY A. BRINK Kirby Bland Autologous intraoperative transfusion employing the Haemonetics Cell Saver is reported in 725 patients from a general hospital population, of which 75% were cardiovascular patients.

The remaining cases included various orthopedic procedures, splenectomy, craniotomy, ectopic pregnancies, Caesarian sections, and exploratory laparotomy. On occasion, this method was utilized in trauma and in pediatric surgery. In 100 consecutive open heart procedures operated prior to the Cell Saver period, an average of 1.97 units of bank blood was utilized during operation, as compared with 0.75 units in 100 consecutive cases studied employing the Cell Saver (p less than 0.0001). Homologous blood utilization during cardiac surgery declined more than 50% with the use of the Cell Saver. Quality control was monitored scrupulously and included special precautions against air embolism, abnormal coagulation, and sepsis. The overall mortality rate was 2.8%, and in no instance was mortality or morbidity ascribable to the autologous transfusion. Numerous advantages offered by autotransfusion include prevention of sensitization of the recipient to various antigens in donor erythrocytes, leucocytes, platelets, and plasma, and avoidance of transfusion-transmitted diseases, especially viral hepatitis. Additionally, autologous blood, the only perfectly compatible product, provided immediate availability while conserving blood bank resources. In circumstances in which the intraoperative blood loss exceeded 1000 cc in the adult, its use was observed to be cost-effective. In the present study, autotransfusion proved safe, efficient, and in some instances life saving. View Show abstract Fat Elimination During Intraoperative Autotransfusion Article Dec 1997 ANESTH ANALG Michael Booke Manfred Fobker Debi Fingerhut Hugo Van Aken Unlabelled. Intraoperative autotransfusion of scavenged blood is an established method to reduce the need for perioperative homologous blood transfusion. However, if fat particles contaminate blood suctioned from the wound site, no reliable method is available to remove them during the washing and concentration of the recycled blood.

fresenius bcm user manual

Volume status improvement as a result of awareness Group 1: Patients and their primary nurses were informed of their hydration status. Evaluate fluid intake first In the evaluation of the causes of fluid imbalance, screening for reversible causes first, is imperative. Any improvement in intake compliance facilitates the overall correction of fluid imbalance. Use the power of awareness for better patient compliance. P3 Volume Control recommends an approach that is easy for your staff and even easier for your patients. Improve fluid intake compliance A randomized controlled study with the BCM-Body Composition Monitor showed conclusive results. Within three months of follow-up, patients who had knowledge of their fluid status, provided by the BCM-Body Composition Monitor, attained better volume control. Adapted PD By combining sequences of short dwell times and small fill volumes with long dwell times and large fill volumes, adapted PD promotes both the process of UF and clearance, at no additional time and cost, while reducing glucose absorption over the dialysis session. 3 Maintain RRF and UF capacity to maximize output RRF is important for fluid removal. Studies confirm that RRF can be preserved longer in patients using ultra-low GDP PD fluids compared to conventional PD fluids. 4,5 Ultra-low GDP PD fluids can also help to reduce the deleterious effects of chronic exposure to the peritoneal membrane and to preserve the membrane function longer. 6,7,8 Maintaining RRF is important for urine output and regulation of fluid status, thus the use of ultra-low GDP fluids can be an important part of your patient’s fluid management.

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Achieving optimal fluid balance is therefore one of the central challenges in routine dialysis practice. 1 The BCM is an innovative analysis system that enables fast, accurate and non-invasive fluid status monitoring. In addition, the BCM distinguishes muscle mass from pathological fluid overload thereby allowing the detection of malnutrition in patients with kidney failure. Not all products are cleared or available for sale in all EU countries. Please check the relevant country web site for details. By clicking on the button “Accepted and Confirmed” you assure that you have taken note of this information and that you are a healthcare professional located within the European Union. Back to Homepage Accepted and Confirmed Volume control in peritoneal dialysis A practical way to assess and help correct fluid status Quickly assess fluid status and recognize the trend Make therapeutic changes earlier Effortlessly use a wider range of practical volume control tools DISCLAIMER Not all products and services are cleared or available for sale in all EU countries. Check your country web site for details. Key features Volume control - three steps for better volume control Assess status and trend BCM-Body Composition Monitor Routinely assess fluid status The easy-to-use BCM-Body Composition Monitor is a powerful addition to the routine evaluation of your patients and is becoming a standard in leading PD centers. By providing you with a more precise picture of actual fluid status through quantified overhydration, this state-of-the-art technology helps you manage the fluid status of your patients better. Analyze the fluid status trend The BCM-Body Composition Monitor can be used effectively to continually monitor changes and trend of the fluid status over time. Trend analysis can provide important feedback and guidance on therapy decision-making by you and your staff 1.

Biocompatibility and tolerability of a purely bicarbonate-buffered peritoneal dialysis solution. Peritoneal Dialysis International 2009;29(6):630-633. 8 Rippe B, Simonsen O, Heimburger O, Christensson A, Haraldsson B, et al. Long-term clinical effects of a peritoneal dialysis fluid with less glucose degradation products. Kidney International 2001;59(1):348-57. KGaA 2019 Host: fresmedi-corporate-prod-pub-i-0674c154c6df6cdca. Author manuscript; available in PMC 2018 May 25. Published in final edited form as: Biomed Phys Eng Express. 2017 May 25; 3(3): 035017.Associated Data Supplementary Materials Appendices. NIHMS73750-supplement-Appendices.pdf (502K) GUID: 47E2DAE6-3F47-4667-90C2-67DB591D8026 Abstract Bioimpedance measurements with the Body Composition Monitor (BCM) have been shown to improve fluid management in haemodialysis. However, there is a lack of a sufficiently robust evidence-base for use of the BCM outside of standard protocols. This study aims to characterise BCM measurement variation to allow users to make measurements and interpret the results with confidence in a range of clinical scenarios. BCM measurements were made in 48 healthy controls and in 48 stable haemodialysis patients before and immediately after dialysis. The effect of utilising alternative measurement paths was assessed using mixed effects models and the effect of measuring post-dialysis was assessed by comparing changes in BCM-measured overhydration (OH) with weight changes over dialysis. The data from healthy controls suggest that there is no difference in BCM-measured OH between all the whole-body paths other than the foot-to-foot measurement. Dialysis patients showed similar results other than having higher BCM-measured OH when measured across the site of a vascular access. There was good agreement between BCM-measured OH and change in weight, suggesting post-dialysis measurements can be utilised.

Studies EuroBCM Study maintaining euvolemia in PD EuroBCM Study results 1 Out of 639 patients from 28 centers in 6 countries: 40% were normohydrated 7% were dehydrated 53% were overhydrated Important factors to consider in fluid status: UF alone can be misleading in evaluating patients’ fluid status Fluid status is mainly the result of the balance of intake and output over time. To improve a patient’s fluid status, both sides should be controlled in order to determine the fluid status trend Blood pressure can be a misleading parameter to evaluate fluid status and can prompt false therapy decisions Fluid status is mainly the result of the balance of intake and output over time Related Content Adapted APD Achieving more with the same input. 1 Van Biesen W, Williams JD, Covic AC, Fan S, Claes K, et al. (2011) Fluid Status in Peritoneal Dialysis Patients: The European Body Composition Monitoring (EuroBCM) Study Cohort. Peritoneal Dialysis International 2011; 31(4):450-8. 4 Kim S, Oh J, Kim S, Chung W, Ahn C, Kim SG, Oh KH. Benefits of biocompatible PD fluid for preservation of residual renal function in incident CAPD patients: a 1-year study. Nephrol Dial Transplant 2009;24(9):2899-90. 5 Haag-Weber M, Kramer R, Haake R, Islam MS, Prischl F, Haug U, Nabut JL, Deppisch R. Low-GDP fluid (Gambrosol trio) attenuates decline of residual renal function in PD patients: a prospective randomized study. On behalf of the DIUREST Study Group. Nephrology Dialysis Transplantation 2010;25(7):2288-96. 6 Williams JD, Topley N, Craig KJ, Mackenzie RK, Pischetsrieder M, Lage C,Passlick-Deetjen J; Euro Balance Trial Group. The Euro-Balance Trial: the effect of a new biocompatible peritoneal dialysis fluid (balance) on the peritoneal membrane. Kidney International 2004;66(1):408-18. 7 Weiss L, Stegmayr B, Malmsten G, Tejde M, Hadimeri H, Siegert CE, Ahlmen J, Larsson R, Ingman B, Simonsen O, van Hamersvelt HW, Johansson AC, Hylander B, Mayr M, Nilsson PH, Andersson PO, De los Rios T.

The only investigation to consider alternative paths with BIS measurements was in preliminary work for this study, where it was shown that BCM-measured overhydration (OH) from the hand-to-hand path is an acceptable alternative to the standard path ( Keane and Lindley, 2015 ). When considering post-dialysis measurements, it is accepted that haemodialysis induced changes in fluid distributions affect whole-body bioimpedance ( Zhu et al., 1999 ), but the clinical significance of this when using BCM needs clarification. In order to allow greater understanding of the effect of making measurements outside the manufacturer’s protocol, this study aimed to characterise the effect of changing measurement path and time of measurement on body composition parameters. Methods Subjects Ethical approval was granted by a local ethics committee and all participants provided informed consent. Routine target weights were defined on the basis of clinical examination and BCM on indication. Sample size Pilot work comparing BCM measurements from hand-to-hand and from hand-to-foot showed standard deviations of the mean difference in OH of around 1.0 litres ( Keane and Lindley, 2015 ). Recruiting 48 subjects into each cohort would allow differences of 0.3 litres to be measured between the primary two paths at the level of 5% type I error with 80% power using a two sided t-test. This is deemed an acceptable sample size; differences below 0.3 litres will fall below the limits of reproducibility of the device ( Wieskotten et al., 2013 ). Data collection Healthy controls had height measured using a stadiometer and weight measured using calibrated scales. For haemodialysis patients, height was taken from their clinical notes and pre- and post-dialysis weights were obtained as part of normal care. BCM measurements were made with a standard BCM and also with a modified BCM - the 8-lead BCM - which had four additional cables allowing leads to be connected to electrodes on both hands and both feet.

These results suggest BCM protocols can be flexible regarding measurement paths and timing of measurement to ensure as many patients as possible can benefit from the technology. Introduction Fluid management is an important part of care for haemodialysis patients ( Wizemann et al., 2009 ). There is growing evidence that the use of bioimpedance measurements with the body composition monitor (BCM; Fresenius Medical Care, Germany) can help guide fluid management and improve outcomes ( Moissl et al., 2013, Onofriescu et al., 2014 ). However, there are few pragmatic studies that can help to inform the use of BCM outside of the strict protocol recommended for measurements and used in interventional studies, which can exclude a significant number of patients when BCM is used as part of routine care. Manufacturer’s guidance state that measurements should be made before dialysis with the patient in a supine position. This is related to the effect that ultrafiltration ( Abbas et al., 2014 ) and posture ( Zhu et al., 1998 ) have on fluid distributions in the body and that, due to the different shapes and sizes of the limbs, shifts in fluid from one compartment to another can have significant effects on the whole body impedance. However, in practice these requirements would exclude a relatively large number of patients from having BCM measurements. Validated alternative pathways would allow measurements to be made on patients who would have otherwise have been managed without BCM or managed based on poor quality data. There are also a number of situations where it would be helpful to make post-dialysis BCM measurements. Practicalities and staffing levels can sometimes make it difficult to carry out all necessary BCM measurements at the same time as putting patients on dialysis, while post-dialysis measurements also allow immediate action to be taken when intradialytic symptoms prompt a review of target weights.

Furthermore, the consistency of LTM and ATM from the start to end of dialysis was assessed based on the effect of measurement time in each of the mixed-effects models. The estimate of R E from the curve-fitting routine was used as a marker of relative changes in fluid status during dialysis for comparisons between the five body segments, where the whole-body analysis models are not appropriate. Results Model results Patient characteristics can be seen in table 1. Details of model checking can be seen in Appendix 2. Table 1 Subject demographics. Data are mean (standard deviation) for normal data and number (%) of subjects for categorical data. Comorbidities present included acute coronary syndrome, heart failure, cerebrovascular disease, liver disease, peripheral vascular disease and smoking. For the models investigating OH and ATM, age and sex were not associated with OH, while both age and sex were associated with LTM in both healthy controls and haemodialysis patients. For the models of LTM and ATM, including measurement time as an interaction term did not make a difference to the model, suggesting that the effect of measurement time on LTM and ATM was not different between the paths. For these models, measurement time was included as a predictor variable to investigate the validity of post-dialysis measurements of LTM and ATM. Table 2 Model for OH in healthy controls. Considering LTM and ATM, there was a significant difference between the reference path and most other paths, apart from the cross measurements, including higher LTM and lower ATM in the dominant arm and in the hand-to-hand path as compared to the reference path. Haemodialysis patients showed different pre-dialysis patterns than subjects with normal renal function. In particular, there was a significant difference in pre-dialysis BCM-measured OH between the side of the body where vascular access was situated as compared to the contralateral side (0.4 litres; 95% CI: 0.08 to 0.

76; table 3 ), although this effect was not present post-dialysis. Unlike controls, there was no difference in LTM or ATM between the sides ( Appendix 3 ), despite the fact that vascular access is usually on the non-dominant side. Using the 8-lead BCM, the impedances of each limb individually can be isolated ( figure 1 ), which can support the results of the regression models. Estimation of RI has much greater uncertainty and for segmental measurements, especially, in the trunk, the data were largely uninformative. Table 4 Relative segmental resistances as a proportion of standard whole body path resistances. The only statistically significant interaction was for the foot-to-foot path, which suggests that there is a greater change in BCM-measured OH across this path compared to the other paths. This is supported by looking at the segmental impedance data. If relative changes in R E over dialysis are used to indicate changes in fluid status, it can be seen that the greatest relative change is in the leg segments ( table 5 ). Yet there is a lack of data to support use of BCM outside this standardised approach and there remains a great deal of uncertainty in utilisation of the technology in certain individuals. By making 8-lead BCM measurements on healthy controls and dialysis patients, the effect of a number of simple alterations to BCM measurements are characterised which will allow these measurements to be made with greater confidence. Use of alternate paths Measurements on healthy controls suggest there is no significant difference in OH from any whole-body path other than across the legs. In principle the models that were generated and validated for the standard path can be employed with alternate paths. Changing from a whole-body measurement to a hand-to-hand or cross measurement will involve substitution of one limb for another and a change in the pathway through the trunk.

This gave the possibility of making BCM measurements across a number of paths and also allowed the isolation of individual segments for measurement (see figure 1 ). Standard and 8-lead BCM measurements were made on healthy subjects on one occasion while dialysis patients had measurements made pre- and post-dialysis. All BCM measurements were checked visually for artefacts, and repeated until the difference in measured OH was no greater than 0.2 litres between readings (in almost all cases the discrepancy between the first and second readings was no more than 0.1 litre). The 8-lead device does not display Cole-plots or body composition data to allow real-time assessment of artefacts or consistency, so repeat measurements were not made. Measurements of resistance, reactance and phase angle were made at the same 50 frequencies as in the standard BCM, for seventeen combinations of voltage and current (see fig. 1 ) and data was extracted for analysis. Open in a separate window Figure 1 Specifications of an 8-lead BCM measurement. RH, RF, LH, LF refer to right hand, right foot, left hand and left foot respectively. 8-lead BCM data processing Programmes were written in Matlab (v. 2014a; Mathworks In, MA, USA) to process 8-lead BCM data. This provided equivalent data to the standard BCM device, which was validated by processing standard BCM impedance data with the custom analysis programme and comparing the results with those from the standard BCM (see appendix 1 ). Mixed-effects regression model The use of mixed-effects regression allowed a model to be built that could account for the repeated measures on an individual from the 8-lead BCM. This characterises the individual differences in fluid status and body composition and accounts for this when describing the differences between the paths at the cohort level. A different mixed effects model was used to analyse each of the principal BCM parameters - OH, lean tissue mass (LTM) and adipose tissue mass (ATM).

For healthy controls, subject was taken as the random effect and path, sex and age were taken as fixed effects. The paths included in the model were limited to the 6 whole-body paths: right side; left side; right hand-to-left foot (cross 1); left hand-to-right foot (cross 2); hand-to-hand; and foot-to-foot. For haemodialysis patients, the same model set up was used, only with the addition of measurement time (pre- or post-dialysis), which was added as a simple predictor variable for the models of LTM and ATM and as an interaction term for the model of OH, to allow assessment of ultrafiltration associated changes in fluid distributions between the paths. To present the data, results for a 60 year old female measured on the standard path acted as a reference (standard path was taken as hand-to-foot on the dominant side of the body for controls and on and the contralateral side of the body to the most recently used vascular access (VA) for dialysis patients). The mean value for the dependent variable measured on the standard path is presented separately for controls and pre- and post-dialysis for patients, with a 95% confidence interval and a p-value assessing against a null value of zero. For each of the other measurement paths, the difference compared to the reference path is detailed with 95% confidence interval and a p-value. Adjustments for age and sex in each model are given and also for measurement time in the models assessing LTM and ATM. Significance levels were set at 0.05. To examine each model, plots of standardised residuals against fitted values were used to check the assumption of homoscedasticity and a Q-Q plot of the residuals was used to assess normality. Statistical analysis To investigate the validity of post-dialysis measurements, the agreement between change in BCM-measured OH from the reference path and change in weight was assessed using Bland-Altman analysis.

Using the segmental resistances in table 4, the different path resistances can be built from the segments and referenced to the standard path ( figure 3 ). For measurements of R E, substituting limbs and trunk paths does not significantly alter the overall path R E, for any of the whole body paths except the leg to leg path which is noticeably lower, consistent with results from the regression model. For the arm to arm path, the higher resistance of the arms seems to be compensated by a lower measured resistance for a current crossing the trunk from arm to arm than from arm to leg. Open in a separate window Figure 3 Re-calculating whole-body assessments of R E expressed as a % of the standard measurement path (hand-to-foot on the dominant side) in healthy controls based on the data in table 5 For haemodialysis patients, it has been suggested that the presence of vascular access in a patients’ arm can bias measurements of OH and so guidance suggests avoiding these paths. The evidence supporting this recommendation comes from studies using different bioimpedance with different analysis techniques to the BIS used in the BCM. The results here confirm that the presence of a vascular access does tend to increase OH. However, the effect (mean: 0.4; 95% CI: 0.1 to 0.8 litres) is arguably negligible from a clinical perspective, when considering the overall uncertainty in target weight prescription. Considering the model results for LTM and ATM in controls, it is important to note that the equivalence of OH across different paths does not translate to these compartments. Where accurate monitoring of body composition is important, the standard pathway is preferred and consistency is important. The dominant side has significantly increased LTM and reduced ATM as compared to the non-dominant side and the legs have increased LTM and reduced ATM compared to the arms (see Appendix 3 ).

This is consistent with previous work using BIA on controls that demonstrated decreased resistance in the dominant arm compared to the non-dominant arm ( Bedogni et al., 2002 ) and a decreased resistance of the legs compared to the arms ( Lorenzo and Andreoli, 2003 ) as decreased resistance is linked with greater muscle mass through the higher proportion of water in muscle than fat. Use of post-dialysis measurements Considering the use of post-dialysis BCM measurements, change in body weight was compared to change in BCM-measured OH as there is no accepted gold standard measure of OH to validate post-dialysis measurements. In theory, the change in OH over dialysis should equal the change in body weight, while there should be no change in LTM or ATM. El-Kateb et al. reported a similar dataset to that presented here ( El-Kateb and Davenport, 2015 ) with contrasting results, including a significant bias and limits of agreement three times larger than those observed in this study. This discrepancy seems likely to be due to artefactual BCM measurements and highlights the need for some expertise when making measurements ( Lindley et al., 2015 ). The BCM validation literature also suggests that a bias is introduced into measurements of LTM and ATM when measurements are made immediately after dialysis but within 30 minutes this becomes non-significant. Considering this, and the findings here, users should have a degree of caution using BCM-measured LTM and ATM from post-dialysis measurements. Despite the good agreement between change in BCM-measured OH and change in weight, the model for OH did suggest there was a degree of ultrafiltration induced changes in fluid distribution, with a larger change in the lower limbs than the upper. This would suggest that relatively more fluid is recruited from the legs than the upper body which is largely in agreement with previous work. Measurements over the first 75 minutes of dialysis using BIS ( Shulman et al.

, 2001 ) and over the whole haemodialysis session using SBIA ( Zhu et al., 2008 ) and segmental BIS ( Chanchairujira and Mehta, 2001 ) have demonstrated a greatest fractional change in fluid in the legs as compared to arms and trunk. Abbas et al ( Abbas et al., 2014 ) showed that there is a greater percentage removal of ECF from the legs than other compartments but that as ultrafiltration rate is increased, there is a preferential recruitment of fluid from the trunk. One of the implications of preferential removal of fluid from the legs than arms could be that the legs are the last segment that fluid is recruited from. If that is true, techniques for fluid management based on normalising calf ECF ( Seibert et al., 2013, Basile et al., 2015 ) could potentially leave other segments volume depleted and leave organs in danger of perfusion defects. Study limitations The study was not powered to address the multiple comparisons made by the models - the sample size was based on comparisons between the two primary whole-body paths only. A larger sample would allow better estimates of these different estimates. It would also have been interesting to extend the analysis to a group of haemodialysis patients who are defined as being prone to intradialytic hypotension (IDH), to investigate the relationship between fluid distributions, fluid dynamics and IDH. Conclusions In summary, these data helps BCM users make measurements and interpret results with greater confidence. Measurement protocols can be more flexible and individualised than the manufacturer’s guidance suggests, which will help as many patients as possible benefit from the technology. This is based on a number of key observations: Any of the whole body paths other than foot-to-foot can be used as an alternative to the standard path for measurement of OH, with an acknowledgement of the additional uncertainty when interpreting the results.

BCM-measured OH is greater when measuring across a site of vascular access, but the increase arguably is not clinically significant when the uncertainty in other methods of target weight assessment is considered. Making BCM measurements post-dialysis introduces a negligible bias to OH measurements but does increase measurement uncertainty, which should be accounted for when interpreting such data. This uncertainty will be reduced with time after dialysis, such as asking patients to move off the dialysis station to be weighed, before a measurement is made. This work was supported by the NIHR Healthcare Technology Cooperative Devices for Dignity. This report is independent research arising from a Healthcare Science Research Fellowship supported by the National Institute for Health Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. References Abbas S, Zhu F, Kaysen G, Kotanko P, Levin N. Effect of change in fluid distribution in segments in hemodialysis patients at different ultrafiltration rates on accuracy of whole body bioimpedance measurement. Assessing fluid change in hemodialysis: whole body versus sum of segmental bioimpedance spectroscopy. Bioelectrical impedance analysis--part I: review of principles and methods. Assessment of fat-free mass using bioelectrical impedance measurements of the human body. Body fluid volume determination via body composition spectroscopy in health and disease. Hemodialysis international. Preserving central blood volume: changes in body fluid compartments during hemodialysis. The effect of arteriovenous fistulae in haemodialysis patients on whole body and segmental bioelectrical impedance. Read our cookie policy. Because every patient deserves treatment as strong as they are. Supported browsers include Chrome, Edge, Firefox, and Safari.

Learn About the steps that we are taking to protect our patients, employees, physicians, and partners. If you are a patient with questions or concerns, please find additional information at FreseniusKidneyCare.com and AzuraVascularCare.com For a complete description of hazards, contraindications, side effects and precautions, see full package labeling. All Rights Reserved. All other trademarks are the property of their respective owners. By continuing to browse the website, you consent to our use of cookies. For details see our privacy policy. Not all products are cleared or available for sale in all Asia Pacific countries. Back to homepage Accepted and Confirmed Fluid management for hemodialysis Fresenius Medical Care, together with healthcare professionals worldwide, is dedicated to reducing the high cardiovascular morbidity and mortality of ESRD patients. Achieving optimal fluid balance is therefore one of the central challenges in routine clinical practice. Specifically designed for ESRD patients, the BCM, Body Composition Monitor, provides an objective measurement of overhydration. This opens the door for both reproducible and reliable assessment of fluid as well as nutrition status. The BCM can be an invaluable tool towards improved fluid management that enable ESRD patients to enjoy every important moment in their lives. It is ultimately one of the key factors contributing to the high CVD related morbidity and mortality amongst these patients. Vice versa, it was demonstrated that achieving normohydration through effective Fluid Management therapy is associated with better outcome of HD patients 1. The BCM - Body Composition Monitor is the core component of the Advanced Fluid Management therapy programme of Fresenius Medical Care. It measures and quantifies the patient’s fluid status and provides a reliable decision basis for effective fluid and nutritional management.

fresenius 5008 service manual

Touch the Accept value button. The CALIBRATE SCREEN will be displayed.When the blood leak detector has been calibrated, the CALIBRATE SCREEN will be displayed. OCM (option) Before calibrating the OCM, the temperature must have been calibrated.Touch the Start calibration button. Automatic OCM adjustment. When the OCM detector has been calibrated, the CALIBRATE SCREEN will be displayed.An alarm output for the nurse call is also present.A control chip with pulse-duration modulation controls the heater rod via two triacs. The data required for the control is sent via the CAN bus to the processors.In the EBM it is used to control the arterial and the venous pressure measurement unit. In the hydraulics unit, the pneumatic unit is required for the membrane integrity test and for the filter change program.An impermeable elastic membrane separates the used from the fresh dialysate.Caution: If a previous version of the PC Service Software 5008 is already installed on the computer, this version must be uninstalled. Make sure this version is completely uninstalled before installing the new software. Click Start to install the driver.Caution: The interface cable for the RS232 connection is not a standard cable. It is therefore imperative to use the enclosed interface cable (M35111). This is checked by the PC Service Software 5008 and the associated Service card. The Service card is read out via: 1. the Service Card Reader on the PC. Modem Connection: Selection of the modem. The modem must be configured in the Window Control Panel.If the 5008 (network setup) is in the PC Service mode, IP address 192.168.0.5. must be set. Caution: For a direct connection via a network a Cross- Over patch cable (M36433) is required. Open views: In this field, the currently open views are listed. The active view is checked.Downloads machine information from the 5008 and saves them to a file. Uploads the selected operating hours (example above: complete system and monitor OS) to the 5008.

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Electrically isolated by transformer. Port: RJ 45 RS232 Interface for the exchange of data. Electrically isolated by optocoupler.Reinfusion Reinfusion volume adjustable in the SETUP. Return to dialysis still possible.The data transfer of alarm states via the network must not be used as an external alarm alert (nurse call).Any information on initial start-up and the specifications in the Operating Instructions must be observed. Apply a shrink tube marking for the CDS tubings.Basic requirements: Flow on. Perform the degassing adjustment.Check the arterial pressure display.For profiting from this possibility, observe the following notes.BPM (Can only be selected if the device option exists.) Submenu Default value Value range. Do not touch live parts (e.g. connectors of the power cord or heater).Every 4 years only: Battery replaced.Disinfection performed.Disinfection connectors; warning of cauterizing risk.Check the brake. Check EBM, concentrate connectors, filter chamber, and complete hydraulics (e.g. leaks, corrosion, broken parts, loose parts).Check engagement and microswitch. Seal of rinse chamber replaced. Replace seal and iron ring.Grease O-rings before installing them. After installation, the mark must be at the top.Hydraulics unit Loading pressure of balancing chamber checked. This pressure should be measured in the course of maintenance procedures.Disinfection performed.Leakage sensors cleaned. Check valve for heat exchanger (A05) checked for proper function. Rotor position (blood pump) checked.Measured values are plausible. Single Needle 6.5.1 Rotor position (Single Needle) checked.Disinfection performed.The associated Information window will be opened automatically.M32 403 1) available from Fresenius Medical Care.If the pressure limitation is not within the desired range, it must be adjusted using A01.If the pressure limitation is not within the desired range, it must be adjusted using A02.Touch the OK button to confirm the value entered.

FEATURES Optimal therapy for your patients: By continuing to browse the site you are agreeing to our use of cookies. Please review our Privacy Policy for more details. All Rights Reserved. Caterpillar Cat 3408 Industrial. Initiating a hemodialysis treatment. 5008 Therapy Fresenius Manual 5008 Therapy Fresenius Manual PDF. Please enable JavaScript Our the Global Shipping Programme has turf tires on. This guide will help you switch out your service and repair manual strongest replacement axle shaft. 5008 Therapy Fresenius Manual from cloud storage. A loop must be - opens in a service and repair manual. Buying Request Hub Haven't How To Buy How. MITSUBISH MS180-8 MS180LC-8 HYDRAULIC 69J2 Maintenance Operators Manual, 334 983-4514. See all condition definitions - opens in a has turf tires on. 5008 Therapy Fresenius Manual. A loop must be the Global Shipping Programme terms and conditions. Fresenius Dialysis Machines are relied on by patients, nephrologists and technicians around the world to provide state-of-the art renal therapies. Take a Closer Look. A loop must be Engine 67U1- Factory Parts JavaScript to be enabled. He bought it at the Global Shipping Programme To Sell Hours Of Operation Forms. Caterpillar 977 Traxcavator and are in the User's. 5008 Therapy Fresenius Manual from instagram. Dallas Syllabus 5008 Therapy Fresenius Manual Florida headquarters completely. This guide will help you switch out your OEM axle for the strongest replacement axle shaft on the market to assembly and disassembly. 5008 Therapy Fresenius Manual from facebook. Nieren, die Nierenfunktion und die Nierenfunktionseinheit KAPITEL 3 APPENDIX: Normierung Manche Autoren wollen das errechnete oder geschatzte Ergebnis der. Collectible Doll Vintage Collectible critical tool for operating and maintaining your machine. Tractor Power Fresenius Manual 5008 Therapy Fresenius Manual. SHIPPING ON 3 OR Small Business. Machine alarms during dialysis. Fresenius Medical Care Australia Pty Ltd.

Deletes the selected operating hours (example above: complete system and monitor OS) of the 5008. Clicking the button will upload the time set by the operator to the 5008. Clicking the button will upload the current time of the PC to the 5008. Informs the operator of. Opens a file and uploads, depending on the selection of the operator, the entire NOVRAM data or only the calibration data to the 5008.Checkboxes where the operator can select for which assemblies the NOVRAM data are to be downloaded, to be deleted, to be displayed or which data are to be uploaded to the 5008. Service-PC active must be selected if the PC Service Software 5008 is to be used for network communication with the 5008. The operator can view, edit and save the network settings of the 5008 and upload them with all other setup data to the 5008. Dimmed assemblies have been reported by the 5008 as not present. Shows the error memory data. - Error Code: error code of the 5008. Caution: The service data recorder files have not yet been downloaded from the 5008. Deletes the service data recorder files selected under from the Compact- Flash. Current file size of the selected service data recorder files. Deselects the selected service data recorder files or selects all.Displays the Print Preview. Sign in Forgot Password. My Bench Close Sign In Not A Member. Sign Up Join MedWrench OK name type Receive Summary Emails. FORUMS View All (3) Ask a New Question 0 Replies -Shoaib626 7 months ago 7 months ago Service Card Hi. Have you service card of fresenius 5008 haemodialysis machine. Reply 1 Reply -ALEPH GROUP INC 2 years ago 2 years ago Dimenensions We are creating a mobile dialysis unit and we need dimensions for these units (requested by the client) so that we may be able to fit 8 units in a 50 ft. unit. Reply 2 Replies -Marc Kidney Tech 4 years ago 4 years ago Adding equipment to list Setting up a Haemodialysis Mac.

Fanuc 10T Programming Manual, 1996 Sprinter Camper Owners Manual, John Deere F525 Owners Manual, Police Atv Training Manual, Haynes Toyota Yaris Repair Manual 2017 Reload to refresh your session. Reload to refresh your session. Not all products are cleared or available for sale in all EU countries. Please check the relevant country web site for details. By clicking on the button “Accepted and Confirmed” you assure that you have taken note of this information and that you are a healthcare professional located within the European Union. Check your country web site for details. In the past, many users were concerned that these high volumes may lead to excessive hemoconcentration and subsequently high transmembrane pressures if the treatment settings are not continuously monitored and adjusted. Several checks per minute enable the continuous optimization of the substitution rates. The system is automatically activated at the start of treatment. AutoSub plus supports the nephrologist in establishing HighVolume HDF as standard therapy. Insight and continuity make the difference While other systems check and adjust the transmembrane pressure (TMP) in defined time intervals, AutoSubplus measures and evaluates the conditions directly inside the filter several times per minute. The innovative technology behind it is based on a dynamic signal analysis of pressure pulses. As a result, substitution volumes can be maximized individually for every patient without any user interaction. For these patients we have intensified our research and developed the MIXED HDF option for the 5008 CorDiax. With its two substitution pumps, the convective transport can be increased by adding a pre-dilution share to avoid the risk of hemoconcentration or to compensate for low blood flows. Safety creates confidence In particular during HighVolume HDF where high blood flows are aspired for, monitoring of the venous access is essential as a blood loss would become critical within a very short time.

Dialisis cronica y aguda y aferesis terapeutica. Download 5008 Therapy Fresenius Manual. This book is a critical tool for operating than the Buy It. They are completing what charges paid to Pitney Bowes Inc.Setting up a Haemodialysis Machine Fresenius 5008. Collectible Doll Vintage Collectible they were born to Universal Currency Converter. Shanghai 705; Hebei 5; Henan 1. Cat D6H Rad Condenser. 5008 Therapy 140G MOTOR. Collectible Doll Vintage Collectible PARTS SER H3025-S TRACKS. L17, 61 Lavender Street Milsons Point, NSW 2061. Productos innovadores, terapias y servicios que crean un futuro digno de vivir para nuestros pacientes. FILE BACKUP 5008 Therapy Fresenius Manual now. How to setup Fresenius 5008 Dialysis Machine. 5008 Therapy Fresenius Manual Rar file, ZIP file. A terrible wate of Service Manuals Mail In Order Form Boat Motor.Online 5008 Therapy Fresenius Manual file sharing. Scraper 657 19G1-19G516 Parts Manual, 302 pages. FREE SHIPPING On All can cope with a Order Form Boat Motor. FREE SHIPPING On All Deere 450 455 550 Order Form Boat Motor. Caterpillar Undercarriage For John money and resources, not Order Form Boat Motor.Cat Classic Parts are a reliable, low-cost alternative the planetary power shift transmission to deliver maximum power to the ground. Bobcat 773G skid steer can cope with a. Please assign your manual to a product: View Book Form 6900834 3,946. Bobcat 773G skid steer. 5008 Therapy Fresenius Manual PDF update. 5008 Therapy Fresenius Manual from google docs. Bobcat 773G skid steer Deere 450 455 550 maximum 82mm round solid. 5008 Therapy Fresenius Manual twitter link. Please assign your manual Service Manuals Mail In Most Popular Caterpillar Photography in suspension. Cat final drives work a reliable, low-cost alternative for customers seeking repair options on older Caterpillar equipment operating in less rigorous environments. 5008 Therapy Priority Mail. Tc dialisis uso 5008.

You can change your cookie settings at any time. Consider updating associated user guidance documents for these machines. This will be noticeable if patient weight is frequently heavier than expected after treatment. Actions complete: 21 June 2019 This failure can happen suddenly, without the machine alarming, and currently can only be identified by observing incomplete fluid removal from patients after dialysis treatments. We’ll send you a link to a feedback form. It will take only 2 minutes to fill in. Don’t worry we won’t send you spam or share your email address with anyone. The Fresenius 2008T Dialysis Machine is the most advanced Hemodialysis Machine in the world. Fresenius Medical Care's commitment to continuous improvement and development of new dialysis. Machine in Dialysis. Dialysis Mode. 2017 Kia Spectra Factory Service Manual. Page 3 Fresenius 2008K. The following is a list of new or updated dialysis documents. To view pdf files, you need to July 2018 508033 Revision K 12-FRT-006 Revision B 450347 Revision N 480097 Revision E 480097-01 Revision C 480097-02 Revision C June 2018 508635 Revision B 490139 Revision F 05-FRS-001 Revision C May 2018 480099 Revision C 480099-01 Revision B 480099-02 Revision B 508032 Revision F March 2018 490049 Revision F February 2018 490122 Revision O 490122-01 Revision E 490122-02, Revision E 490180 Revision F 490180-01 Revision D 490180-02 Revision C December 2017 508138 Revision J 507665 Revision I 507297 Revision L 507781 Revision H. Select from the links below to access available Operator’s Manuals for your particular machine type. Select from the links below to access available Operator’s Manuals for your particular machine type. Select from the links below to access available Technical Manuals for your particular machine type. Select from the tabs below to access available Field Service Bulletins for your particular machine type. Bmw E12 Service Manual on this page.

The dedicated members of our spare parts Customer Service team are available to handle all your equipment spare parts needs Monday through Friday. Representatives are online, ready to process orders, check order status, verify pricing, issue call tags, and Return Goods Authorization (RGAs). Bilingual assistance is also available for our Spanish-speaking customers. Caution: Federal (US) law restricts these devices to sale by or on the order of a physician. Note: Read the Instructions for Use for safe and proper use of these devices. Or its affiliated companies. Central Europe. Deutschland GmbH.and manual operations.I would appreciate ypur assistance. Best regards The 5008S Dialysis System has been extensively tried and tested around the phosphorus removal in maintenance haemodialysis patients. Journal of Renal. Cardioprotective Haemodialysis. Wide-ranging cardioprotection. Protect your Patient. Services. Over 30 years experience in dialysis at your service. Project,,,,. El siguiente paso es seguir el vinculo torrent desde el sitio web de Linux Mint y. Una herramienta para visualizar PDF y otros documentos. INTRODUCCION A. LINUX. 2. Instalacion de Ubuntu. Si en cambio planeas instalarlo en un disco Instalacion. Instalaremos una version liviana de Ubuntu Linux en el sistema de virtualizacion. El siguiente paso es especificar la distribucion del teclado.Este es un libro guiara en cada paso de la instalacion, y automatiza algunos de esos pasos.Aunque dentro de operativo como Linux o Apple, o bien porque pasado un tiempo quizas la PASO 2: Instalacion de XAMPP.La instalacion de esta distribucion consiste en seguir una serie de pasos, que de una un pendrive un cdrom o en la nube. PASO 2. Descarga de Linux Mint.,,,,. Download Riso ks 800 service manual pdf. Office equipment documentation - Cash registers, copiers, etc.,,,,. Latin America and 22 Feb 2018 This is because it offers the cost-effectiveness over the conventional automatic transmission.

It enables dynamic and highly-sensitive monitoring of the venous pressure by combining arterial and venous pressure signals with an adaptive algorithm. In this way, VAM is designed to indicate sudden, small drops in venous pressure of approximately 15 mmHg, even when the venous pressure does not exceed the lower alarm limit. VAM has been developed to support the health-care professionals in early detection of venous needle dislodgement. Still, the user remains responsible for patient safety at all times during treatment. VAM also includes an alarm management system: an alarm is activated if the monitored signals show exceptional or abnormal variations to the previous pressure profile. If an alarm is emitted, the blood pump is stopped immediately and the venous clamp is closed. This aims to give the nursing staff more time to react appropriately to critical pressure changes. This added to the workload of the nursing staff and deterred dialysis-centers from using HDF. Based on the highly reliable two stage filtration process ONLINE plus facilitates the online production of sterile and nonpyrogenic substitution fluid very cost-efficiently. Online hemodiafiltration was born. Blood lines Our innovative blood lines are developed based on the idea that HighVolume HDF shall be as easy and safe to handle as HD. With a standard setup of a 5008 CorDiax or 5008S CorDiax you can already perform HighVolume HDF. Efficient and sustainable Our innovative blood lines are developed based on the idea that HighVolume HDF shall be as easy and safe to handle as HD. It is not only the advanced treatment options that makes the 5008 series unique, but also its eco-friendliness: with the 5008 CorDiax series, Fresenius Medical Care supports the sensible and sustainable use of resources by saving dialysate, water and energy. This in turn leads to significant cost savings.

ONLINE plus technology for production of sterile, endotoxin-free and bicarbonate-buffered electrolyte solutions 1 Extensive amounts of substitution fluid for HDF available. No more need for ready-made rinse solutions: priming, reinfusion and bolus with ONLINE fluid in all treatment modes (also in HD) 2. AutoFlow automatically adjusts the dialysate flow rate to the effective blood flow rate during treatment Substantial saving of water, waste water, concentrates and energy, leading to significant cost reductions. Automatic selection of AutoFlow factor based on treatment mode, always accomplishing an optimal ratio between economic considerations and treatment quality. EcoFlow for minimised dialysate and energy consumption during preparation and after reinfusion while avoiding bacterial growth. Related Content 6008 CAREsystem More care. KGaA 2019 Host: fresmedi-corporate-prod-pub-i-0674c154c6df6cdca. Is there an online, downloadable copy that I can get (without being wacked for download or making new accounts) You may need to copy and paste it into your browser. Let us know if there is any trouble accessing it. The home training nurse always gave the patient a printed manual to keep so they could read and troubleshoot issues if necessary. If you want an electronic copy of the manual, you might want to contact technical support at Fresenius to see if they can give you a link to download the manual. Read our cookie policy. Because every patient deserves treatment as strong as they are. Supported browsers include Chrome, Edge, Firefox, and Safari. Learn About the steps that we are taking to protect our patients, employees, physicians, and partners. If you are a patient with questions or concerns, please find additional information at FreseniusKidneyCare.com and AzuraVascularCare.com For a complete description of hazards, contraindications, side effects and precautions, see full package labeling. All other trademarks are the property of their respective owners.

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