Spectra Optia Apheresis System Operator's Manual
Spectra Optia Apheresis System Operator's Manual
Apheresis System
Operator’s Manual
Spectra Optia® Apheresis System
Operator’s Manual
TERUMOBCT.COM
Contents
Chapter 1: Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
About This Operator’s Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Conventions Used in this Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Numbered Steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Touch screen buttons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Bullets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Warnings, Cautions, and Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Spectra Optia Apheresis System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Contraindications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Warnings and Cautions for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Warnings for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
System warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
Service warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Electrical warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
General procedural warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Exchange procedure warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Collection and depletion procedure warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
General tubing set warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Accessory set warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Fluid warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Seal Safe system warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Cautions for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
System cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Service cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
General procedural cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Collection and depletion procedure cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
General tubing set cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Exchange Set cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Collection Set cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
IDL Set cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Fluid cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Seal Safe system cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Service Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Special Use of Additional Equipment and Devices During Apheresis Procedures . . . . . . . . . . . . . . . . . . . . . . . 15
Fluids Administered During Apheresis Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Saline Solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Anticoagulant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
ACD-A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Hydroxyethyl Starch (HES) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Replacement Fluids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Adverse Events of Apheresis Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Reactions to Blood Products Transfused During Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Disposal of Infectious and Non-Infectious Waste . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Return of Used Product . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Chapter 2: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Spectra Optia System Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Spectra Optia System Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Front Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Pumps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Valves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Sensors and detectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Return line air detector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Centrifuge Chamber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Filler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
AIM System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Operating Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Automatic Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Semi-Automatic Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Procedure States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Packing Factor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Operation Status Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Caution Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Fluid Balance Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Spectra Optia System Touch Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Navigating the Procedure Screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Entering and changing numerical data using the data entry pad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Screen Colors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Screen Buttons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Buttons, Icons, and Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Chapter 8: Therapeutic Plasma Exchange with a Secondary Plasma Device (TPE-SPD) Procedures . . . . 97
Functional Description of a Therapeutic Plasma Exchange With a
Secondary Plasma Device (TPE-SPD) Procedure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Preparing to Perform a Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Selecting the Procedure and Loading the Tubing Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Navigating the TPE-SPD Procedure Screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Menu Buttons and Tabs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Descriptions of Buttons, Icons, and Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Entering and Changing Data During the Run . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Entering and Confirming Patient and Procedure Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Entering Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Reviewing and Confirming the Plasma Device Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Reviewing and Confirming the Run Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Connecting the Plasma Device Using an Extension Tubing Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Setting Up and Priming the Extension Tubing Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Connecting the Treated Plasma Bag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Saline prime: Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Saline prime: No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Priming the Inlet Line and the Return Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Connecting the Patient and Starting the Run. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Filling the Treated Plasma Bag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Chapter 13: White Blood Cell Depletion (WBCD) and Platelet Depletion (PLTD) Procedures . . . . . . . . . . 177
Functional Description of a White Blood Cell Depletion (WBCD) or a
Platelet Depletion (PLTD) Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Preparing to Perform a Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Anticoagulant Solutions for WBCD Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Using ACD-A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Using HES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Selecting the Procedure and Loading the Tubing Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Navigating the WBCD and PLTD Procedure Screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Menu Buttons and Tabs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Descriptions of Buttons, Icons, and Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Entering and Changing Data During the Run . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Entering and Confirming Patient and Procedure Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Entering Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Reviewing and Confirming the Run Values and the Fluid Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Entering and changing the fluid data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Priming the Inlet Line and the Return Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Positioning the IV Pole and the Replacement Fluid Container . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Connecting the Patient and Starting the Run. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Monitoring the Run. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
Main Run Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
Collection Status Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
Collection preference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
Return to patient and collect into bag buttons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
Monitoring the Patient. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Managing Citrate Toxicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Optimizing the Run. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Facilitating the Flow of Replacement Fluid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Improving the flow of replacement fluid contained in bottles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Optimizing the Collection Preference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Monitoring the contents in the collect line and adjusting the color . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Minimizing Buffy Coat Accumulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Targeting a Lower Collect Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Addressing Clumping in the Connector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Chapter 15: Ending the Run and Completing the Procedure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Ending the Run Before a Run Target is Attained . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
Ending the Run After a Run Target is Attained. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
Ending the Run . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
Extending the Run . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
Completing the Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
Disconnecting the Patient and Sealing the Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
Sealing the lines using the Seal Safe System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
Reviewing the Data on the Procedure Summary Screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
Starting a New Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Removing the Tubing Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Numbered Steps
All step-by-step instructions are numbered and the numbers appear in bold, as shown in the following example:
1 Unpack the system from the shipping container.
When steps are numbered, the sequence in which they are performed is important. Always perform the steps in the
order presented.
Bullets
Bullets (•) are used to indicate items in a list.
Caution: Cautions alert the operator to the possibility of a problem with the device associated with its use or
misuse. This includes device malfunction, failure, and damage to the device or other property.
Intended Use 1
The Spectra Optia Apheresis System, a blood component separator, may be used to perform the following
therapeutic apheresis, cell collection, and cell processing procedures*:
• Therapeutic plasma exchange
• Therapeutic plasma exchange with a secondary plasma device
• Red blood cell exchange, depletion, and depletion/exchange
• Mononuclear cell collection from the peripheral blood
• Granulocyte collection from the peripheral blood
• White blood cell depletion
• Platelet depletion
• Processing of harvested bone marrow
*Procedure availability varies by country.
4 Use only the filler and the tubing sets that Terumo BCT manufactures for the Spectra Optia system.
5 The manufacturer, assembler, installer, or importer regards itself as responsible for effects on the safety,
reliability, and performance of the device, only if the device is employed in accordance with the instructions
for use.
6 The Spectra Optia system can interfere with EKG monitoring when a patient is simultaneously undergoing
apheresis and EKG monitoring.
7 The Spectra Optia system alarms are inactive when the system is turned off.
Service warnings
8 To avoid possible patient injury or loss of life, use only maintenance procedures published by Terumo BCT.
9 Terumo BCT will not be responsible for patient safety if the procedures to maintain and calibrate the
Spectra Optia system are other than those specified by Terumo BCT. Individuals performing the procedures
must be appropriately trained and qualified.
10 Only a qualified service representative should perform equipment modifications. Any modifications must be
approved in writing by Terumo BCT.
11 Turn off the system before cleaning or disinfecting to prevent possible electrical shock or damage to the
equipment.
12 The power cord should be unplugged from the wall to isolate the device from the power supply before
servicing. Do not position the device to make it difficult to unplug the power cord.
13 Only a qualified service representative should service or repair the Spectra Optia system.
14 When cleaning and disinfecting equipment surfaces that might have been exposed to blood, take adequate
precautions to prevent possible exposure to and transmission of infectious diseases.
Electrical warnings
15 All electrical installations must comply with all applicable local electrical codes and Terumo BCT’s
specifications.
16 To avoid the risk of electric shock, plug the system into a properly installed, three-wire, grounded electrical
receptacle that is protected by an approved branch circuit overcurrent protection and disconnection device.
The branch circuit protection and disconnection device must be located away from, but close enough to, the
system so that the system can be easily disconnected from the main power supply if the centrifuge
malfunctions.
17 Non-medical electrical equipment connected to the Ethernet connection should not be located within the
patient environment. The definition of “patient environment” can be found in the IEC standard
60601-1 Edition 3.1, definition 3.79.
18 Accessory equipment connected to the analog and digital interfaces must be certified according to the
respective IEC standards (e.g., IEC 60950 for data processing equipment and IEC 60601-1 for medical
equipment). The installer of accessory equipment is responsible for the integrated medical system
compliance with requirements of IEC 60601-1 Edition 3.1. If you are in doubt, contact your Terumo BCT
service representative.
21 It is advisable to obtain the patient’s detailed drug history before each apheresis procedure. For those drugs
potentially affected by apheresis procedures, the physician should either adjust the doses or give the
22
medications immediately after the procedure.
To avoid potential side effects and complications during apheresis, patients taking angiotensin-converting
enzyme (ACE) inhibitors should discontinue these medications before the procedure. The patient’s
1
attending physician should prescribe and supervise this and any medication change before apheresis.
23 The operator must verify the correct input of information relevant to the safety of each apheresis procedure.
24 When preparing to perform a procedure, ensure that the lines are connected to the correct fluids, and that
fluid is flowing into the drip chambers:
• AC line (orange) to the anticoagulant container
• Saline line (green) to the saline (0.9%) container
25 Check that the tubing is correctly loaded in all pumps before starting a procedure. Visually inspect each
pump to ensure that tubing does not protrude.
26 Before starting a procedure, inspect all lines, especially those in the centrifuge and on the front panel, to
ensure that they are not obstructed. Tubing that is occluded or mechanically constrained can lead to
malfunction or fluid imbalance. Inlet and return lines perform without difficulty as long as the interior
diameter of the tubing is larger than the interior diameter of the patient’s inlet and return access.
27 Residual ethylene oxide (EO) found within a Spectra Optia system tubing set may cause allergic, including
anaphylactoid and anaphylactic, reactions. The Spectra Optia system allows you to rinse the tubing set with
saline solution when you are concerned about hypersensitivity reactions associated with the residual EO,
which is a result of sterilization. This option is available to select before you connect the patient. Refer to
‘‘Selecting and Performing a Custom Prime’’ on page 79 for instructions on performing a saline rinse.
28 Only blood or blood products should be processed in the centrifuge.
29 If you are using a blood warmer on the return line, ensure that you completely prime the blood warmer
tubing set to remove all the air in the set before you connect the patient.
30 When connecting a blood warmer tubing set to the return line, ensure that the tubing connection is tight.
Put the luer connection no higher than 20 in (50 cm) above the return access to prevent the possibility of air
entering the tubing.
31 Before connecting the patient, check the inlet and return lines for air. If air is present in the lines, remove the
air before connecting the patient.
32 Monitor the return line for air. If you see air in the line, go to the operation status screen, touch Remove Air
From Return Line, and follow the instructions on the screen.
33 Before connecting the patient, ensure that the AC line contains anticoagulant at the inlet manifold.
34 The inlet and return pressure sensors are not intended to detect infiltrations of the vein. Monitor the patient
for infiltrations.
35 Tubing sets may occasionally fail, which could result in the loss of blood, blood products, or the
introduction of air into the tubing set. It is very important that the operator watch for leaks in the cassette,
all tubing and welds, and in the channel while the set is in use. Operators should take adequate precautions
in handling blood and blood products in accordance with their facility’s standard operating procedures.
36 When handling extracorporeal blood circuits, take adequate precautions to prevent the possible exposure to
and transmission of infectious diseases.
37 You must completely close the inlet saline line when the system instructs you to do so. If the line is left open,
the additional saline will dilute the blood in the channel, which could result in an ineffective procedure.
38 To avoid potential side effects and complications for patients that have a low blood volume (LBV) or a low
hematocrit (Hct), the Spectra Optia Apheresis System recommends performing a custom prime of the
tubing set for patients whose extracorporeal volume (ECV) is greater than 10% or 15% of their total blood
volume (TBV), or if their extracorporeal red blood cell volume (ERCV) is greater than 10% or 15% of their
red blood cell volume (RCV). The attending physician should prescribe the appropriate procedural settings
for the patient.
39 When performing a custom prime using red blood cells (RBC), ensure the unit contains a sufficient number
of RBC or RBC volume (RCV) to adequately fill the extracorporeal circuit of the tubing set. An insufficient
RCV may lead to an unintended decrease in patient hematocrit. The system will calculate the necessary
extracorporeal RCV based on the patient data entered (TBV and Hct), the tubing set and filler used, if a
blood/fluid warmer is used, and the type of procedure being performed.
40 Terumo BCT does not recommend the use of a diluted RBC unit to perform a custom prime. A diluted unit
may not contain a sufficient number of RBC or RBC volume (RCV) to compensate the patient for the RCV
required to adequately fill the extracorporeal circuit of the tubing set. If a diluted unit is used, the patient
may experience a decrease in hematocrit and may be unable to tolerate the procedure. The attending
physician should assess the patient’s condition and determine the appropriate RCV of the unit used.
41 The following can cause fluid imbalance:
• Administration of replacement fluid that is not at room temperature during a procedure
• Use of improperly vented fluid containers
• Equipment malfunction
• Improperly clamped or closed lines, or improperly loaded valves
• Use of inadequately primed or clotted filters on the replace line of the Exchange Set
• Tubing that is incorrectly loaded in the pumps
42 The alarm system is inactive during a manual rinseback. If you must perform a manual rinseback, watch for
air in the return line. If you see air, immediately discontinue the rinseback.
43 Do not apply excess pressure to the vent bag when pushing fluid from the reservoir to the patient during a
manual rinseback or you could damage the red blood cells that you are returning to the patient.
44 Do not continue to squeeze the vent bag after the fluid in the reservoir reaches the level of the reservoir filter
during a manual rinseback. If you continue to squeeze the bag, you could deliver air to the patient.
45 Do not touch Unload to unload the tubing from the pumps or remove the tubing set when a patient is
connected to the Spectra Optia system, or the patient may receive surplus fluids through the inlet and return
lines.
46 All used disposable materials should be considered hazardous, and should be handled and disposed of at the
end of the procedure in accordance with all applicable regulations.
47 Turn off the system before cleaning to prevent possible electrical shock or damage to the equipment.
0.5 39
1.0 63
1.5 78
2.0 86
49 Terumo BCT does not recommend performing rinseback during RBCX procedures. The data that the
system uses to predict the run targets does not include rinseback volume. If rinseback is performed, the run
targets may not be accurate.
50 Before performing a therapeutic plasma exchange procedure with a secondary plasma device (TPE-SPD
procedure), carefully review the instructions for use provided by the manufacturer of the secondary plasma
device.
51 Some secondary plasma devices can leach small amounts of potentially toxic substances to patients and must
be flushed before use. Flush the device according to the manufacturer’s instructions to ensure patient safety.
52 Some secondary plasma devices can remove significant quantities of plasma-circulating proteins, including
important clotting factors and albumin. The attending physician should evaluate each patient and prescribe
replacement proteins, if appropriate.
53 If a TPE-SPD procedure is being performed on a patient who has a TBV of 1 liter or less, Terumo BCT
recommends that the treated plasma bag and the AC container be weighed throughout the TPE-SPD
procedure to assess and manage the fluid balance.
Fluid warnings
62 When using biologically-derived replacement fluids, closely monitor the patient for reactions.
63 Use only the fluids specified in this manual when performing procedures on the Spectra Optia system. Using
a fluid with a different composition or concentration could cause hemolysis.
64 Before using hydroxyethyl starch (HES) for a procedure performed on the Spectra Optia system, consult the
manufacturer’s package insert for potential contraindications and adverse events.
69 Ensure that the sealer head and the tubing are free of moisture and debris before using the Seal Safe system.
70 Moisture on the surface of the tubing or the sealer head may cause an electrical arc to occur between the jaws
when the power is applied, terminating the sealing process. If an arc occurs, carefully inspect the seal to
ensure it is satisfactory. 1
71 Ensure that there is no tension on the tubing when operating the Seal Safe system. Stretching the hot tubing
could cause a leak.
72 Do not submerge the Seal Safe system in liquid or you may receive an electric shock.
73 Disconnect the sealer head from the RF cable before cleaning to avoid receiving a serious radio frequency
(RF) burn during the cleaning process.
74 The jaw on the sealer head contains an indentation where the spring rests. If you do not properly seat the
spring in the indentation after cleaning, you may damage the spring, which could cause inadequate tubing
seals.
75 Do not open the sealer head to service the device or you may receive an electric shock. Contact a qualified
service representative to service the device.
8 Before installing a filler or loading a tubing set, inspect the filler and visible interior of the centrifuge
chamber for fluid spills or structural damage. Ensure the metal band around the perimeter of the filler is
centered and secure.
9 To avoid damage to the centrifuge and the filler, do not operate the centrifuge if the filler latch is not
lowered and locked in place. Ensure that the filler cannot be pulled off the gear train without unlocking and
raising the filler latch.
10 To avoid personal injury or damage to the system, use proper lifting techniques when lifting the
Spectra Optia system.
11 Ensure that the wheel pedal is pressed to the right side (locked position) and the rear wheel brake levers are
locked during procedures, so that the Spectra Optia system does not move.
12 When the wheel pedal is not in the locked position (pressed to the right side) and the rear wheel brake levers
are released, ensure at least one person is in continuous contact with and controls the movement of the
Spectra Optia system.
13 Only perform procedures when the system is on a smooth, dry, level surface.
14 Do not leave the device unattended in a traffic area.
15 In the event of a prolonged power interruption, the use of an uninterruptible power supply (UPS) may allow
the operator to discontinue the procedure and perform rinseback. However, a UPS does not ensure that the
operator can complete the procedure as intended.
16 When using the Spectra Optia system with another device, consult the device manufacturer’s instructions for
use for any precautions or contraindications for using the device in proximity to equipment that emits
electromagnetic energy.
17 The use of cables other than those specified by Terumo BCT could result in improper function of the
Spectra Optia system.
18 Portable RF communications equipment including peripherals, such as antenna cables and external
antennas, should be located no closer than 30 cm (12 in) from any part of the Spectra Optia system
including cords, or the system may not perform properly.
Service cautions
19 Clean the Spectra Optia system using a mild, non-abrasive cleaning solution or a mild detergent. Industry
standard practice defines mild cleaning solution and mild detergent as a solution or detergent that is safe on
skin and on washable surfaces, such as dishwashing liquid. Use of a solution that is not compatible with the
materials on the system may damage the material or operating characteristics of the system.
20 Disinfect the Spectra Optia system using a disinfecting solution that is compatible for use on the system.
Use of a disinfecting solution that is not compatible could damage the material or operating characteristics
of the system.
21 Use only a gauze pad, a lint-free cloth, or a wipe when cleaning or disinfecting the touch screen, the covers
on the AIM system lights in the centrifuge, and the aperture plate on the filler. Use of an abrasive brush,
scrub material, or a sharp object can damage the surface of the components.
22 To avoid damaging the touch screen, do not douse the touch screen with fluid or leave fluid on the screen
after cleaning or disinfecting the screen. Always dry the screen with a gauze pad or a clean cloth after
exposing it to fluid.
23 Terumo BCT has validated the methods described in this manual for cleaning and decontaminating the
Spectra Optia system. Before using an alternative method, verify that it will not damage the system.
24 Do not lubricate pumps or pump rotors for any reason.
26
it is imperative that the operator monitor the patient and the system throughout the procedure.
The physiological condition of patients may affect the outcomes of procedures performed on the
1
Spectra Optia system.
27 Patients with impaired or abnormal citrate metabolism (for example, if the patient has liver or renal disease)
may present an increased risk of citrate sensitivity. Attending physicians should assess the appropriateness of
such patients for apheresis procedures and prescribe how they should be monitored during procedures.
28 Use aseptic technique throughout all procedures to ensure patient safety or product quality.
29 Terumo BCT has validated the system's performance when the extracorporeal circuit is properly
anticoagulated using ACD-A, and recommends using ACD-A to anticoagulate the circuit.
30 The higher the inlet:AC ratio used during the procedure, the greater the risk is for platelet aggregates and
clots to form in the tubing set.
31 For patient comfort and optimal system operation, ensure that the fluids used during the procedure are at
room temperature before connecting them to the tubing set.
32 Before loading the tubing set, confirm that the filler that is installed is the correct filler for the procedure.
Using the incorrect filler will compromise the performance of the system and the outcome of the procedure.
33 Do not connect the fluids to the tubing set before the system instructs you to do so.
34 To avoid a failed test of the tubing set, do not raise and lower the cassette after there is fluid in the set.
35 Handling and transfusion of blood products should be conducted in accordance with applicable standards
and regulations, and performed under the direction of a licensed physician.
36 If you leave the roller clamp on the saline line completely open when the patient is connected, you will
quickly infuse a large volume of saline to the patient.
37 Before using the injection port on the inlet line to infuse medication to the patient during a procedure, you
must pause the system or the medication will be pumped into the extracorporeal circuit instead of to the
patient.
38 If you use the injection port on the return line to infuse fluid or medication, monitor the patient for
hypervolemia. The Spectra Optia system cannot account for the additional volume of fluid infused through
the injection port.
44 When performing a collection procedure using the Collection Set or the IDL Set, seal the collect line above
the T-shaped connector to the plasma line as shown in the illustration below. If you seal the collect line
below the connector, the cells in the collection bag could flow back into the tubing set when the system
raises the cassette.
45 When using hydroxyethyl starch (HES) during a procedure, you must add 46.7% trisodium citrate solution
to the HES for anticoagulation. Failure to use the correct solution can result in inadequate anticoagulation
of the extracorporeal circuit, ineffective sedimentation and collection of cells, and adverse patient reactions.
46 If hydroxyethyl starch (HES) is not used during a PMN collection procedure, the collection efficiency will
be lower.
47 If you use a low inlet pump flow rate during a CMNC procedure, it will take the system longer to process
the required volume to establish the interface and to collect the target cells. Be aware of how this is relevant
to a patient with a small total blood volume. Also, try to avoid conditions that will cause a delay in
establishing the interface, such as pump pauses.
56 To prevent damage to the needleless injection port housing, do not overtighten the connector. Do not use
any instruments to tighten the connection.
61 To correctly lock the needle protector over the inlet needle, you must hold it in place while you pull the
tubing to remove the needle. The needle protector will not lock if you use the wings of the needle or the
body of the needle protector to remove the needle. After use, visually confirm that the needle protector is
locked over the needle and that the wings are secured behind the locked prongs.
Fluid cautions
62 Hydroxyethyl starch (HES) is not approved or available for use in some countries for apheresis procedures.
Check your country regulations before you consider using HES for a procedure on the Spectra Optia
system.
Service Information
Terumo BCT or its subsidiaries will not be responsible for the safety, reliability, or performance of this equipment
unless:
• Operational procedures, calibration, and repairs are carried out by appropriately qualified persons.
1
• All equipment modifications are authorized in writing by Terumo BCT and performed by appropriately
qualified persons.
• The electrical installation of the relevant room complies with all applicable local electrical codes and IEC
requirements.
• The equipment is used in accordance with the published instructions for use.
Detailed service information for this equipment, including schematic diagrams and recommended service
procedures, is available from your Terumo BCT representative.
Saline Solution
Use sterile 0.9% sodium chloride injection to prime the tubing set and to perform the procedure.
Anticoagulant
ACD-A
Each 100 mL of ACD-A contains 2.2 g sodium citrate hydrous, 730 mg citric acid anhydrous, and 2.45 g dextrose
hydrous.
Citrate toxicity
ACD-A can cause citrate toxicity in certain patients. Mild forms of this condition are generally recognized by
peripheral paresthesia, tingling sensations in the extremities, and/or restlessness. Severe forms of this condition can
result in significant cardiac dysfunction. Terumo BCT recommends that you frequently assess the condition of the
patient throughout the apheresis procedure.
Replacement Fluids
Careful selection and use of appropriate replacement fluids contributes to the maintenance of the patient’s plasma
oncotic pressure and blood pressure. During TPE and depletion procedures, the patient response to decreasing
blood viscosity and plasma protein levels may vary and be difficult to predict. In addition, non-target cells may be
depleted and may require replacement. Therefore, the physician should prescribe the type and volume of
replacement fluid used. The prescription should consider the patient’s fluid status, protein balance, and other
pertinent factors that the physician believes could affect the patient’s condition.
1 2
13 13
3
5 4
6 7 15
14
8
16
17
11 18
12 19
10
12
Figure 2-1: Spectra Optia Apheresis System front and back views
Component Function
1 Monitor with touch screen Allows you to communicate with the system.
2 Dual IV pole Has hooks for hanging bags and containers. You can adjust the height of the pole for
transporting the device, or to hang and remove bags.
3 Accessory bracket Can be used to hold an additional device used during an apheresis procedure, such
as a blood warmer or an infusion pump.
4 Seal Safe system Used to seal the lines of the tubing set. The system generates a radio frequency (RF)
electromagnetic field between the jaws of the sealer head to seal the tubing.
7 Power switch Allows you to turn power to the system on and off.
8 View port Allows you to look through the centrifuge door to see the interface in the channel.
Component Function
11 Wheel pedal Allows you to secure the front wheels in a forward position to facilitate control when
moving the device. Also allows you to lock the wheels in place so that the system
does not roll.
12 Rear wheel brake levers Allow you to lock the rear wheels in place to prevent the machine from moving.
15 IV pole release button Allows you to raise and lower the IV pole by pressing the button.
17 Power cord holder Secures the power cord during transport and storage.
18 Circuit breaker Protects the device from electrical damage by monitoring the current and shutting of
the flow of power if the current gets too high.
19 Ethernet port Allows you to connect the system to an external device to export data or to print a
procedure report.
Note: Spectra Optia system operators are allowed to remove the system components listed below. All other
components must be removed by a qualified service representative.
• Pump rotors
• Tubing set
• Filler
• Seal Safe system sealer head and RF cable
• Accessory bracket
• Power cord and power cord clamp
• Ethernet cable, if used
Front Panel
The front panel of the Spectra Optia system holds the pumps, sensors, and valves that are used to perform an
apheresis procedure. The components of the front panel are shown in Figure 2-2, and are described in Tables 2-3
through 2-5.
18 19
2
5
17 6 7 8
11
12
1 10 16
9 14 4
13 15
2 3
Figure 2-2: Front panel components (cassette tray shown in the lowered position)
Pumps
Table 2-3: Pumps
Pump Function
1 AC (anticoagulant) pump Pumps anticoagulant from the AC container into the inlet line.
2 Inlet pump Pumps anticoagulated blood from the patient into the channel.
4 • Replace pump (exchange) • Exchange procedures: Pumps replacement fluid out of the fluid container and into
• Collect pump (collection, the reservoir.
depletion) • Collection and depletion procedures: Pumps the targeted component out of the
(Pump has a black dot on the channel or the chamber and into the collection bag or the reservoir.
pump rotor.)
Valves
Table 2-4: Valves
Valve Function
6 RBC valve Directs the flow of red blood cells from the channel.
8 • Remove valve (exchange) Directs the flow of the separated blood components pumped from the channel.
• Collect valve (collection,
depletion)
Sensor/Detector Function
9 Inlet pressure sensor Monitors negative pressure in the inlet line to ensure that adequate inlet pressure is
maintained.
10 Low-level reservoir sensor Monitors the volume of fluid in the reservoir, and ensures that air does not enter the
return line.
11 Return pressure sensor Monitors positive pressure in the return line to ensure that the correct level of return
pressure is not exceeded.
12 High-level reservoir sensor Monitors the volume of fluid in the reservoir to help control the volume of fluid in the
tubing set.
13 Centrifuge pressure sensor Monitors pressure in the channel and lines in the centrifuge to ensure that the
correct level of pressure is not exceeded.
14 Barcode reader Reads the tubing set identification number on the cassette to ensure that the correct
tubing set is loaded for the procedure selected.
15 RBC detector • Exchange procedures: Detects red blood cells in the plasma line.
• MNC collection procedures: Detects red blood cells in the collect line.
16 • Plasma pressure sensor • TPE with a secondary plasma device (SPD) procedures: Monitors pressure in the
(exchange) plasma line.
• Collect pressure sensor • Collection and depletion procedures: Monitors pressure in the collect line.
(collection, depletion)
17 Return line air detector Monitors air in the return line. Signals the system if the patient has excess air in
(Detector is a component of the circulation.
return pump.)
18 AC fluid detector Detects fluid in the anticoagulant (AC) line. Signals the system if the line contains air
instead of fluid.
19 Replacement fluid detector Exchange and depletion procedures: Detects fluid in the replace line. Signals the
system if the line contains air instead of fluid.
signals the system and an alarm occurs. Follow the instructions on the alarm screens to perform an air removal to
remove the air from the line.
During an air removal the system pumps 18 mL of saline into the return line to flush the fluid in the line into the
reservoir and the air into the vent bag. The total volume of saline delivered to the patient for the air removals
performed is displayed on the operation status screen during the run and on the procedure summary screen after
the procedure has been completed.
Warning: Monitor the return line for air. If you see air in the line, go to the operation status screen, touch
Remove Air From Return Line, and follow the instructions on the screen.
2
Centrifuge Chamber
The Spectra Optia system centrifuge spins to create a centrifugal force that separates the blood into cellular
components. The centrifuge chamber houses the centrifuge and the system components, as shown in Figures 2-3
and 2-4, and described in Table 2-6.
4
3 5
2
7
4
6
9
8 10
5
Figure 2-3: Centrifuge chamber components Figure 2-4: AIM system light behind the gear shroud
Component Function
1 Upper collar holder Secures the upper collar at the entrance to the centrifuge chamber.
2 Centrifuge arm Holds the upper bearing holder. Lowers the filler latch if the latch is left in the raised
position when the centrifuge spins.
3 Upper bearing holder Secures the upper bearing to the tip of the centrifuge arm.
4 AIM system lights (2) Illuminate the filler and the connector to allow the AIM system to determine the position
One light is located on the of the interface. Each light is protected by a clear plastic cover.
ceiling of the centrifuge
chamber, and one light is
located on the floor of the
chamber behind the gear
shroud (Figure 2-4).
5 Strobe lights (2) Provide illumination for viewing different areas of the channel through the view port.
7 Filler (standard filler is shown) Secures the tubing set channel, the connector, and the lines that are attached to the
connector to the centrifuge.
8 Lower bearing holder Secures the lower bearing at the entrance to the loading port.
10 Loading port Allows access to the filler for loading the tubing set.
Filler
The filler secures the tubing set channel, the connector, and the lines that are attached to the connector to the
centrifuge. The Spectra Optia system has two fillers: the standard filler and the IDL filler. Confirm that you are
using the correct filler for the procedure before you load the tubing set. See Table 5-1 on page 62 for instructions
on the correct filler to use for each procedure.
The fillers and components are shown in Figures 2-5 and 2-6. The components are described in Table 2-7.
2
1 1
2 2
3 3
6
4 4
5 5
Component Function
1 Centrifuge collar holder Secures the lower collar of the tubing set at the opening to the centrifuge loading port.
4 Aperture plate Plastic component that is attached to the underside of the filler directly beneath the
opening for the connector (Figure 2-7). Ensures uniform lighting to the appropriate
areas of the connector. Helps the AIM system control the concentration of cells that flow
through the collect port during a collection or depletion procedure.
5 Optical reference Black corner piece that provides a reference point for the AIM system to use to
determine the position of the interface during a procedure (Figures 2-8 and 2-9).
6 Chamber bracket (standard Secures the chamber onto the standard filler if a Collection Set is used.
filler only)
Figure 2-8: Optical reference Figure 2-9: Optical reference (shown with the connector
loaded)
AIM System
The AIM system is an optical detection system that is composed of hardware and software, and that interprets the
interface position in the tubing set connector during procedures on the Spectra Optia system. To accurately
interpret the interface position, the AIM system focuses on the optical reference on the filler, which is illuminated
by the AIM system lights in the centrifuge chamber.
The AIM system has three main functions:
• Monitor the interface position.
2
• Interpret the interface position and measure the intensity of the light passing through the connector.
• Adjust the plasma pump flow rate to maintain the optimal interface position so that the target blood
components can be collected or removed.
For additional information about how the AIM system functions during each procedure, see the procedure
functional descriptions in Chapters 7 through 14.
Operating Modes
The Spectra Optia system has two modes of operation: Automatic mode and Semi-Automatic mode. Below are
descriptions of the two modes.
Automatic Mode
During Automatic mode, the system uses the configuration parameters and the procedure data entered to
determine and control the pump flow rates, centrifuge speed, packing factor, run targets, and to establish the
interface position. The AIM system monitors the interface position, so that the desired blood components can be
collected or removed, and the fluid remaining in the channel can be returned to the patient.
Semi-Automatic Mode
During Semi-Automatic mode, the AIM system does not control the position of the interface. The software
controls the interface position using the entered hematocrit and other procedure values during TPE procedures.
During collection procedures, the operator can use the up and down arrows on the collection status screen to adjust
the interface position. For information about the reasons for entering Semi-Automatic mode and instructions for
using Semi-Automatic mode, see “Using Semi-Automatic Mode” on page 219.
Procedure States
Table 2-8 describes the Spectra Optia system’s procedure states. Both Automatic mode and Semi-Automatic mode
include these states.
Table 2-8: Procedure states
State Description
Load Operator selects the procedure and loads the appropriate tubing set.
Tubing set test System verifies that the correct tubing set is loaded, and confirms the function of the pumps,
valves, and sensors.
Prime System primes the tubing set to remove air from the set, to perform volumetric tests, and to
balance the pumps prior to the start of the run. The system also verifies that the correct filler is
installed.
Run Operator connects the patient and the system performs apheresis according to the selected
procedure.
Rinseback System returns the blood remaining in the tubing set to the patient after the run is complete to
reduce the patient’s RBC loss. The operator may choose to perform or skip rinseback.
Disconnect test System verifies that the lines to the patient are clamped. During a collection procedure, the
system also verifies that the collect line to the collection bag is sealed.
Unload System raises the cassette and unloads the tubing from the pumps.
Packing Factor
The packing factor represents the relationship between the inlet pump flow rate and the centrifuge speed during the
run. It indicates how tightly the cells are packed in the channel. When the inlet pump flow rate is increased or
decreased, the centrifuge speed increases or decreases accordingly. The packing factor is displayed on the main run
screen.
Using the optimal (default) packing factor ensures that more of the target cells or components are collected or
removed and that more of the non-target cells or components are returned to the patient. See Chapters 7
through 14 for the default packing factor for each procedure. If the inlet pump flow rate used is high or very low, it
may not be possible for the system to achieve the optimal packing factor because the centrifuge has already reached
its maximum or minimum speed. The centrifuge cannot spin any faster or slower to accommodate the change to
the inlet pump flow rate.
If you are performing a CMNC, a PMN collection, or a WBCD procedure and conditions require that you use a
packing factor that is not the default, be aware that an excess number of platelets could be collected. The system
displays a warning screen with instructions for monitoring the patient for platelet depletion and for resuming the
procedure in Caution status.
• Proceed to Semi-Automatic mode • TPE Allows you to change the mode of operation in response to an
• Proceed to Automatic mode • SPD alarm condition or to troubleshoot certain procedure conditions.
• MNC
• CMNC
• PMN
• WBCD
• PLTD
• BMP
• Disable RBC detector • TPE Allows you to disable or enable the RBC detector in response to an
• Enable RBC detector • SPD alarm condition or to troubleshoot certain procedure conditions.
• RBCX • MNC collection procedures: If the RBC detector is disabled, the
• MNC collection phase control automatically changes to Operator.
• Disable RBC too soon alarm MNC Allows you to change the frequency of the alarm that occurs when
• Enable RBC too soon alarm RBC are detected in the collect line before the chamber is full. To
prevent the alarm from occurring each time cells are detected,
disable the alarm. If you decide you want the alarm to continue to
recur, you can re-enable it.
Remove air from return line All procedures Allows you to initiate an air removal if you see air in the return line
and an alarm has not occurred.
Total saline to patient: volume mL All procedures Displays the total volume of saline that was delivered to the
patient as a result of the air removals performed during the
current procedure.
Caution status: Reason for Caution All procedures Explains the reason for Caution status. See “Caution Status” on
status page 32 for details about conditions that cause the system to
enter Caution status.
Caution Status
Caution status alerts you that the system is operating outside of certain established limits. When the system is
operating in Caution status, a yellow line appears on the bottom of the screen. The yellow line disappears if the
system operation changes and Caution status no longer applies. To view the reason why the system is operating in
Caution status, touch the Operation Status tab. The reason is shown in yellow text on the operation status screen.
Certain conditions that cause the system to enter Caution status are procedure-specific. Table 2-10 describes the
conditions that cause the system to enter Caution status during each procedure.
Table 2-10: Conditions for Caution status
Procedure Condition
All procedures Target or actual AC infusion rate exceeds 1.2 mL/min/L of the patient’s TBV.
TPE Patient data or procedure data that was entered caused the predicted fluid balance to be less than 90%
or greater than 110% of the patient’s TBV.
SPD Patient data or procedure data that was entered caused the target or actual fluid balance to be less
than 85% or greater than 140% of the patient’s TBV.
RBCX Patient data or procedure data that was entered caused the predicted fluid balance to be less than 95%
or greater than 105% of the patient’s TBV.
MNC • Patient data or procedure data that was entered caused the target or actual fluid balance to be less
than 85% or greater than 140% of the patient’s TBV.
• Control selected for the collection phase is Operator.
CMNC • Patient data or procedure data that was entered caused the target or actual fluid balance to be less
than 85% or greater than 140% of the patient’s TBV.
• Return to Patient button on the collection status screen was touched. Cells are not being collected.
• Packing factor that was entered exceeds the default. An excess number of platelets may be collected.
• Procedure data that was entered caused the packing factor to exceed the default. An excess number
of platelets may be collected.
PMN • Patient data or procedure data that was entered caused the target or actual fluid balance to be less
than 85% or greater than 115% of the patient’s TBV.
• Return to Patient button on the collection status screen was touched. Cells are not being collected.
• Packing factor that was entered exceeds the default. An excess number of platelets may be collected.
• Procedure data that was entered caused the packing factor to exceed the default. An excess number
of platelets may be collected.
• Target or actual collect volume exceeds 15% of the patient’s TBV. An excess number of RBC may be
collected.
WBCD • Patient data or procedure data that was entered caused the target or actual fluid balance to be less
than 85% or greater than 115% of the patient’s TBV.
• Return to Patient button on the collection status screen was touched. Cells are not being collected.
• Packing factor entered exceeds the default. An excess number of platelets may be collected.
• Procedure data that was entered caused the packing factor to exceed the default. An excess number
of platelets may be collected.
PLTD • Patient data or procedure data that was entered caused the target or actual fluid balance to be less
than 85% or greater than 115% of the patient’s TBV.
• Return to Patient button on the collection status screen was touched. Cells are not being collected.
BMP Return to BMP Bag button on the collection status screen was touched. Cells are not being collected.
Procedure
Fluid Balance Limits (% TBV)
Hypovolemia Hypervolemia
2
TPE 75 125
SPD 75 220
RBCX 75 125
MNC 75 N/A
CMNC 75 N/A
PMN 75 125
WBCD 70 125
PLTD 70 125
1
2
3
Area Description
1 Menu bar Contains menu buttons that you touch to show or hide menu tabs.
3 Message bar Displays information about the status of the procedure or instructions to enter data.
4 Activity area Displays tasks to complete and buttons that allow you to do the following:
• Navigate to another screen.
• Change the operating mode.
• Change values or information about the procedure.
5 Action bar Contains buttons that you touch to perform the action stated on the button or to
navigate to a different screen.
Entering and changing numerical data using the data entry pad
To enter numerical data or to change a numerical value for certain operating parameters during the procedure,
touch the button for the parameter and use the data entry pad that the system displays on the screen. See
Chapters 7 through 14 for more information about entering and changing data during the run.
Screen Colors
The Spectra Optia system uses a color scheme to indicate the different procedure states, allowing you to quickly
determine the progress of the procedure. Table 2-13 describes the color that corresponds to each procedure state.
Table 2-13: Color schemes for procedure states
Unload, procedure summary, next procedure (patient has been disconnected) Burgundy
Screen Buttons
The screen displays active and inactive buttons, as shown in the following examples:
• Active button:
Active buttons are colored according to the procedure state and appear as if they are raised. Touch an active
button to enter, change, or save data, or to proceed to the next activity or action.
• Inactive button:
Inactive buttons are gray. They indicate that the action or the information is not available.
Alarm mute button (Icon on the Bottom left side of alarm Allows you to mute the alarm tone during
button depends on the screens an alarm condition. The tone is
software version in use.) automatically restored if another alarm
occurs.
(muted)
(muted)
Stop button Bottom left corner of the Stops the centrifuge and pauses the
monitor pumps.
Active alarm Bottom left side of the screen Indicates an active alarm. Takes you to
button during an alarm condition an active alarm screen or to a list of
active alarms, if more than one alarm is
active.
Clock button • Run time graph on the main Allows you to view clock time or elapsed
run screen time for the run.
• Exchange procedures: Run
time graph on the exchange
status screen
Up and down scroll buttons • Active alarm screens Allows you to view additional information
• Alarm history screen on the screen.
• Procedure selection screen
Check mark icon • Procedure preparation screen Appears on buttons. Indicates that the
• Patient data screen required task is complete or the
selection is confirmed.
Do not connect Bottom right side of the screens Safety feature that reminds you that the
patient icon before the patient is connected patient should not be connected during
the current operating state.
Semi-Automatic mode icon Bottom right side of the run Indicates that the system is operating in
screens Semi-Automatic mode.
Interface graphic TPE procedures: Main run Displays a representation of the current
screen interface and the thickness of the buffy
coat in the connector.
Collect port image Collection and depletion Shows a real-time image of cells flowing
procedures: Main run screen, through the collect port.
collection status screen
Algorithm control icon TPE procedures: Main run Indicates that the AIM system is not
screen controlling the interface position. The
system is using certain procedure data
to control the position instead.
Blood drop icon RBCX procedures: Allows you to enter the values for
• Run values screen defective RBC instead of the fraction of
• Run targets screen cells remaining (FCR) for an exchange or
Appears on a button on the data a depletion/exchange procedure.
entry pad. Touch FCR to toggle
to .
Single-needle icon TPE procedures: Main run Indicates that the single-needle option
screen was selected and confirmed.
Hash mark icon • Run values screen Allows you to enter the number of
• Run targets screen collection phases instead of the target
Appears on a button on the data collect volume.
entry pad. Touch mL to toggle
to #.
Test tube icon MNC collection procedures: Graph on the collection status screen
Collection status screen only. Indicates that the control selected
for the collection phase is Inlet.
Inlet volume processed icon MNC collection procedures: • Indicates the inlet volume processed
• Main run screen (mL) during the current accumulation
• Collection status screen phase.
• Run targets screen • Indicates the inlet volume processed
(mL) during the current and previous
accumulation phases.
RBC detected icon MNC collection procedures: Graph on the collection status screen.
Collection status screen Indicates the inlet volume that was
processed before the RBC detector
detected cells in the collect line.
Operator override icon • TBV (total blood volume) • Indicates that the operator entered the
button on the patient data patient’s TBV instead of using the
screen volume the system calculated.
Not equal icon MNC collection procedures: Indicates that the current volume in the
• Run values screen bag may be different from the displayed
• Run targets screen volume because plasma was transferred
• Procedure summary screen from the plasma bag into the collection
bag.
Up and down arrow buttons TPE-SPD procedures: Data Allows you to adjust the volume in the
entry pad that appears if you treated plasma bag.
touch Replace on the main
run screen
Caution: Only perform procedures when the system is on a smooth, dry, level surface.
4 Open the centrifuge door and confirm that the filler latch on the filler is lowered and locked. Close the
centrifuge door.
5 Remove the following components and transport them separately to avoid damage to the system and the
components:
• Blood warmer and accessory bracket, if used.
• Seal Safe system sealer head and cable.
Caution: To avoid possible damage to the Seal Safe system, always disconnect the sealer head and the
RF cable before transporting the Spectra Optia system.
6 If you are transporting the system in a vehicle, cover the system with a heavy-duty cover or a shipping
blanket to protect the system.
8 To lock the rear wheels in place, press down on each of the rear wheel brake levers (Figure 3-3).
2 If the vehicle does not have a liftgate, perform steps a. through c. to load the system in a horizontal position
into the vehicle.
Note: Before transporting the system in a horizontal position, consider removing the filler from the
centrifuge chamber and transporting it separately. This helps to minimize wear on the centrifuge and reduce
the risk of damage to components inside the centrifuge chamber.
a. Tip the system backward so that the front wheels are off the ground.
b. Use the specially-designed lift handles, if installed, or the metal frame of the device to lift the system into
the vehicle. Do not use the bumpers or the blue side panels for lifting, or you may damage the system.
Always use proper lifting technique when lifting the system.
c. Lay the system in the vehicle so that it rests on the rear wheels and the two wheels on the handle of the
system.
System
Table 4-1 shows the operating parameters to configure for the system.
Time format
be selected. The language cannot be changed after the
procedure is selected.
Software Software version and verification value for each type of Not configurable
procedure.
This information is used to confirm that the system
software version and the verification value for a
particular procedure type have not changed after
software for a new procedure type was installed.
Procedure
Table 4-2 shows the operating parameters to configure for procedures.
Pressure alarm limit: Limit at which an inlet pressure alarm occurs. −250 to −100
Inlet (mmHg) (Default: −250)
Pressure alarm limit: Limit at which a return pressure alarm occurs. 200 to 400
Return (mmHg) Default: 400
AC container: Volume (mL) Volume of AC in the AC container used during the 250 to 1000
procedure. Default: 1000
Report
Table 4-3 shows the operating parameters to configure for the report.
Paper Size of paper that is used to print the report if “Printer” • Letter
is the device selected. • A4
Default: Letter
IP address IP address for the device that is used to print the report. Device-specific
The format for the address is XXX.XX.XXX.XXX. The first
five digits must be 172.21 to match the system’s
4
address.
Port Port number for the device that is used to print the 100 to 9999
report. The format for the number is XXXX. It is Default: 9100
recommended that you use the default number.
Connection Test that is used to verify that a device for printing a Not configurable
report is connected to the system.
Touch Test to verify the connection. If the system can
verify the connection, “Passed” appears on the button.
If the system cannot verify the connection, “Failed”
appears.
Report Type of procedure report that you want to view or print. • Summary
There are two types of reports: • Detail
• Summary: Single-page report including the system Default: Summary
serial number, the date of the procedure, the patient
data, the fluid balance, and the initial and final run
values)
• Detail: Summary report plus additional procedure
details, which are reported according to time
configured for the report update interval.
Table 4-4: Parameters and setting options to configure for a TPE procedure
Inlet:AC ratio (__:1) Ratio of the inlet pump flow rate to the AC pump flow 6 to 15
rate. The configured ratio represents the ratio at the Default:10
start of the run.
Plasma volumes Run target. Number of the patient’s plasma volumes to 0.5 to 4
exchanged be exchanged, accounting for the amount of AC in the Default: 1
plasma removed.
The configured number represents the number the
system uses to calculate the initial run values.
Table 4-5: Parameters and setting options to configure for a TPE-SPD procedure
Inlet:AC ratio (__:1) Ratio of the inlet pump flow rate to the AC pump flow 6 to 15
rate. The ratio configured represents the ratio at the Default:10
start of the run.
Plasma volumes treated Run target. Number of the patient’s plasma volumes to 0.5 to 4
be treated, accounting for the amount of AC in the Default: 1
plasma removed.
The number configured represents the number the
system uses to calculate the initial run values.
Table 4-6: Parameters and setting options to configure for a secondary plasma device
Saline prime Indication that a saline prime of the plasma device will • Yes
be performed. • No
Default: No
Replace pump balance (%) Percentage change in the replace pump flow rate that is 50 to 150
required to balance the flow rates of the replace pump Default: 100
and the plasma pump so that the desired volume of
treated plasma is maintained in the treated plasma bag.
Plasma pressure alarm Limit at which the operator is notified that the pressure 50 to 1350
limit: Maximum (mmHg) in the plasma line is too high. Default: 250
Table 4-7: Parameters and setting options to configure for an RBCX procedure
Inlet:AC ratio (__:1) Ratio of the inlet pump flow rate to the AC pump flow 6 to 15
rate. The configured ratio represents the ratio at the Default: 13
start of the run.
Table 4-8: Parameters and setting options to configure for an MNC collection procedure
Run target: Run time (min) Time required to complete the run. 40 to 480
The run starts when the patient is connected and ends Default: 0
when the run targets have been attained. When you
enter a value for this parameter, the system
automatically sets the targets for the whole blood
processed and the TBV processed to zero.
Run target: TBV processed Number of the patient’s total blood volumes to be pro- 1 to 10
cessed. Default: 2
If you enter a value for this parameter, the system
automatically sets the targets for the whole blood
processed and the run time to zero.
Plasma: Plasma bag (mL) Volume of plasma to be collected into the plasma bag. 0 to 500
Default: 0
Plasma: Collection Volume of plasma to be collected into the collection bag. 0 to 500
bag (mL) Default: 0
Chamber flush (mL) Volume of plasma the system uses to flush cells from 6 to 100
the chamber into the collection bag during the collection Default: 16
phase.
Chamber chase (mL) Volume of plasma the system uses to rinse any cells 0 to 100
remaining in the collect line between the chamber and Default: 2
the collect valve into the collection bag.
The chamber chase occurs after the chamber flush and
before the collect valve moves into the return position.
Table 4-9: Parameters and setting options to configure for the use of AC during an MNC collection procedure
Inlet:AC ratio (__:1) Ratio of the inlet pump flow rate to the AC pump flow 6 to 15
rate. The configured ratio represents either the target Default: 12
ratio if inlet:AC ratio ramping is indicated, or the ratio at
the start of the run.
Inlet:AC ratio ramping Indication that the system will ramp the inlet:AC ratio at • Yes
the start of the run. • No
The system processes the first 100 mL of inlet volume Default: Yes
at a ratio of 8.0:1. While processing the next 100 mL,
the system ramps the ratio to the target ratio. Ramping
is automatically disabled if you choose to perform a
custom prime.
4
Continuous Mononuclear Cell Collection (CMNC)
Tables 4-10 and 4-11 show the operating parameters to configure for a CMNC collection procedure.
Table 4-10: Parameters and setting options to configure for a CMNC collection procedure
Run target: Run time (min) Time required to complete the run. 40 to 480
The run starts when the patient is connected and ends Default: 0
when the run targets have been attained. If you enter a
value for this parameter, the system automatically sets
the targets for the whole blood processed and the TBV
processed to zero.
Run target: TBV processed Number of the patient’s total blood volumes to be 1 to 10
processed. Default: 2
If you enter a value for this parameter, the system
automatically sets the targets for the whole blood
processed and the run time to zero.
Plasma collection: Plasma Volume of plasma to be collected into the plasma bag. 0 to 500
bag (mL) Default: 0
Plasma collection: Volume of plasma to be collected into the collection bag. 0 to 500
Collection bag (mL) Default: 0
Table 4-11: Parameters and setting options to configure for the use of AC during a CMNC procedure
Inlet:AC ratio (__:1) Ratio of the inlet pump flow rate to the AC pump flow 6 to 15
rate. The configured ratio represents the ratio at the Default: 12
start of the run.
Table 4-12: Parameters and setting options to configure for an PMN collection procedure
Run target: Run time (min) Time required to complete the run. 40 to 480
The run starts when the patient is connected and ends Default: 0
when the run targets have been attained. If you enter a
value for this parameter, the system automatically sets
the targets for the whole blood processed and the TBV
processed to zero.
Run target: TBV processed Number of the patient’s total blood volumes to be 0.5 to 5
processed. Default: 0
If you enter a value for this parameter, the system
automatically sets the targets for the whole blood
processed and the run time to zero.
Inlet:AC ratio (__:1) Ratio of the inlet pump flow rate to the AC pump flow 6 to 15
rate. The ratio configured represents the ratio at the Default:13
start of the run.
Plasma (mL) Volume of plasma to be collected into the plasma bag. 0 to 500
Default: 0
HES Indication that hydroxyethyl starch (HES) will be used for • Yes
the procedure. • No
The selection determines the default packing factor: Default: Yes
• Yes: Default packing factor is 1.6
• No: Default packing factor is 4.5
The selection also appears on the top left side of the
main run screen.
Table 4-13: Parameters and setting options to configure for a WBCD procedure
Run target: Run time (min) Time required to complete the run. The run starts when 40 to 480
the patient is connected and ends when the run targets Default: 0
have been attained.
If you enter a value for this parameter, the system
automatically sets the targets for the whole blood
processed and the TBV processed to zero.
4
Run target: TBV processed Number of the patient’s total blood volumes to be 0.5 to 5
processed. Default: 2
If you enter a value for this parameter, the system
automatically sets the targets for the whole blood
processed and the run time to zero.
Inlet:AC ratio (__:1) Ratio of the inlet pump flow rate to the AC pump flow 6 to 15
rate. The ratio configured represents the ratio at the Default: 12
start of the run.
HES Indication that hydroxyethyl starch (HES) will be used for • Yes
the procedure. • No
The selection determines the default packing factor: Default: No
• Yes: Default packing factor is 1.6
• No: Default packing factor is 4.5
The selection also appears on the top left side of the
main run screen.
Table 4-14: Parameters and setting options to configure for a PLTD procedure
Run target: Run time (min) Time required to complete the run. The run starts when 40 to 480
the patient is connected and ends when the run targets Default: 0
have been attained.
If you enter a value for this parameter, the system
automatically sets the targets for the whole blood
processed and the TBV processed to zero.
Run target: TBV processed Number of the patient’s total blood volumes to be 0.5 to 5
processed. Default: 1.5
If you enter a value for this parameter, the system
automatically sets the targets for the whole blood
processed and the run time to zero.
Inlet:AC ratio (__:1) Ratio of the inlet pump flow rate to the AC pump flow 6 to 15
rate. Default: 10
The ratio configured represents the ratio at the start of
the run.
Table 4-15: Parameters and setting options to configure for BMP procedure
Table 4-16: Parameters and setting options to configure for using a blood warmer
Replace line Indication that a blood warmer will be connected to the • Yes
replace line during a procedure using an Exchange Set. • No
Default: No 4
Tubing set (mL) Volume of the blood warmer tubing set on the return 1 to 100
line. Default: 40
The system uses this information to adjust the
calculation for the extracorporeal volume, the minimum
volume required for a custom prime, and the volume of
saline required for rinseback.
3 Push the filler locking pin (Figure 5-1, number 2) toward the center of the centrifuge. With the pin pushed
in, grasp the edge of the filler and lift up to raise the filler off the centrifuge.
1
2
Figure 5-1: Location of the filler latch pin (1) and the filler locking pin (2)
Figure 5-2: Notches on the filler aligned with the pins on the centrifuge
2 Verify that the filler is secure by pulling it upwards. If the filler is properly locked, it should remain firmly in
place.
5
3 Lower the filler latch.
Caution: You may load the tubing set up to 24 hours before the procedure as long as you do not lower the
cassette or prime the set. Once you lower the cassette or prime the set, you must use the set during the same
work shift.
Note: Single-use tubing sets for the Spectra Optia system are considered applied parts because they make contact
with the patient. The tubing sets comply with the Class II Type BF electrical safety requirements of IEC 60601-1.
1 Verify that the tubing set has not expired by checking the expiration date on the cover of the package.
2 Document the lot number of the tubing set to use for future reference.
3 Touch Prepare Tubing Set. The screen appears instructing you to prepare the set.
Exchange Set
1 Take the line holder out of the package. The line holder holds the replace line (white clamps), the AC line
(orange), the saline line (green), and the extra remove line (yellow clamp). The remove bag with the attached
remove line is located inside the line holder.
2 Take out the remove bag and the extra remove line. Put the remove bag with attached lines on the right side
of the centrifuge cover.
3 Take out the replace line and put the line over the right side of the front panel.
4 Take out the AC line (orange) and the saline line (green) and hang the lines over the left side of the front
panel. Set the empty line holder aside.
5 Take the vent bag out of the package and hang the bag on the left side of the IV pole.
6 Take out the coiled inlet line (red clamps) and remove the paper tape from the coil. Hang the inlet
connection on the left end of the IV pole. Repeat this step with the return line (blue clamps).
7 Hang the remove bag on the IV pole.
Collection Set
1 Take the product bags and the vent bag out of the package and hang the bags from left to right on the IV pole
in the following order: vent bag, plasma bag, collection bag.
2 Take out the coiled inlet line (red clamps) and remove the paper tape from the coil. Hang the inlet
connection on the left end of the IV pole. Repeat this step with the return line (blue clamps).
3 Take out the AC line (orange) and the saline line (green) and hang the lines over the left side of the front
panel.
IDL Set
1 Take the product bags and the vent bag out of the package and hang the bags from left to right on the IV pole
in the following order: vent bag, plasma bag, collection bag.
2 Take out the replace line and put the line over the right side of the front panel between the two sides of the
IV pole.
3 Take out the coiled inlet line (red clamps) and remove the paper tape from the coil. Hang the inlet
connection on the left end of the IV pole. Repeat this step with the return line (blue clamps).
4 Take out the AC line (orange) and the saline line (green) and hang the lines over the left side of the front
panel.
2
Figure 5-3: Cassette snapped into the cassette tray
Ensure that there is nothing lodged behind the cassette or the tray that could interfere with the loading. 5
3 Press on the top corners of the cassette to snap the cassette into the tray.
6 Pull the channel up through the loading port and then through the opening in the center of the filler. To
avoid damaging the chamber and the collect line when using a Collection Set, guide the chamber through
the loading port with one hand as you pull the channel through the loading port with the other hand
(Figure 5-4). Lower the filler latch and lock it in place.
Figure 5-4: Channel pulled through the loading port (Collection Set shown here)
7 Position the lower collar in the collar holder on the filler latch so that the inlet line (pink line) is not
obstructed by the other lines. Ensure that either the base of the pink line aligns with the space between the
two screws (Figure 5-5, number 1) or is adjacent to the indentation on the filler latch.
8 Grasp the centrifuge loop below the lower collar and gently pull the collar down until you hear the “click” of
the locking pin as it pops out and locks the collar in the collar holder. Ensure that the notch at the base of
the locking pin (Figure 5-5, number 2) is visible. If the collar is locked, you can see the notch.
Figure 5-5: Lower collar correctly positioned and locked with the notch on the locking pin visible
9 Starting with the connector (Figure 5-6, number 1), insert the channel into the groove in the filler, finishing
with the inlet port (Figure 5-6, number 2). Run your finger over the groove and push down any section of
the channel that is not completely inserted in the groove. The channel must sit flush with the groove.
1 2
Figure 5-6: Channel pressed into the groove (Exchange Set shown here) 5
10 If you are using a Collection Set, put the chamber (Figure 5-7, number 3) into the chamber bracket. Ensure
that the chamber sits behind the clip at the opening of the bracket, so that the clip retains the chamber in the
bracket. Put the collect line to the chamber behind the lip of the optical reference (Figure 5-7, number 4), so
that the line does not block the optical reference.
Figure 5-7: Collect line correctly positioned behind the lip of the optical reference
Loading the Lower and Upper Bearings and the Upper Collar
1 Insert the narrow part of the lower bearing into the lower bearing holder (Figure 5-8) and the narrow part of
the upper bearing into the upper bearing holder (Figure 5-9). Ensure that the braided section of the loop is
not twisted.
Figure 5-8: Lower bearing inserted in the lower bearing Figure 5-9: Upper bearing inserted in the upper bearing holder
holder
2 Position the upper collar below the upper collar holder and insert the line into the holder (Figure 5-10). Pull
the line up to secure the upper collar in the holder (Figure 5-11).
Figure 5-10: Line inserted in the upper collar holder Figure 5-11: Upper collar secured in the upper collar holder
Note: The menu buttons at the top of the screen are active so that you may enter or change the patient data or the
procedure data during the prime.
Custom prime • TPE Allows you to fill the tubing set with specified fluid (RBC, plasma, or albumin)
• Yes • SPD after you prime the set with saline and before you connect the patient.
• No • RBCX Performing a custom prime helps to maintain isovolemia when the patient has a
• MNC low RBC volume or a low total blood volume, such as a pediatric patient. After
• CMNC the custom prime is complete and the run is started, the fluid used is pumped
• PMN from the channel to the patient before the system establishes the interface.The
• WBCD default setting for performing a custom prime is No.
• PLTD
HES • PMN Allows you to indicate the use of hydroxyethyl starch (HES) during a procedure.
• Yes • WBCD The default setting is the configured setting.
• No
Saline rinse All procedures Allows you to rinse the tubing set with saline solution when you are concerned
• Yes about hypersensitivity reactions associated with residual ethylene oxide in the
• No tubing set, which is a result of sterilization. This option is available to select
before you connect the patient. The default setting for performing a saline rinse
is No.
Single Needle TPE Allows you to indicate the use of a single access to perform a procedure. The
• Yes default setting for the single-needle option is No.
• No
Collect plasma BMP Allows you to specify whether the system should collect plasma at the end of
• Yes the run. The system uses procedure data to determine the optimal plasma
• No volume to collect, but you may change the volume during the run. The default
setting to collect plasma is the configured setting.
Blood warmer • TPE Allows you to indicate the use of a blood warmer on the replace line without
• Replace line • SPD having to change the configured setting. The default setting for using a blood
• RBCX warmer is the configured setting.
Plasma collection CMNC Allows you to indicate when the configured volume of plasma should be
• Before the run starts: collected during the run. The selections change depending on whether the run
• Beginning of run has started. The default setting for plasma collection is End of Run.
• End of run
• After the run starts:
• Now
• End of run
Selecting Rinseback
Warning: Terumo BCT does not recommend performing rinseback during RBCX procedures. The data that the
system uses to predict the run targets does not include rinseback volume. If rinseback is performed, the run
targets may not be accurate.
6
The system considers the patient’s TBV and the fluid balance safety limit when determining the volume of fluid
that can be used to perform rinseback. There are four stages of rinseback. If the patient’s fluid balance has reached
the maximum limit for the procedure, the system might not complete all four stages. The stages are as follows:
• Stage 1: The system pumps the blood out of the channel for return to the patient. If you are using an
Exchange Set or a Collection Set, the system returns approximately 50 mL of volume to the patient. If you are
using an IDL Set, approximately 115 mL of volume is returned.
• Stages 2 through 4. During each stage, the system performs the following steps:
a. Pumps 20 mL of saline into the channel.
b. Restarts the centrifuge, spins the centrifuge to rinse the channel, and then stops the centrifuge.
c. Pumps the contents out of the channel for return to the patient.
If you intend to perform rinseback, confirm that the selection for rinseback is Yes. The system prompts you to
perform rinseback at the end of the run. If you do not want to perform rinseback, change your selection to No. If
you selected a custom prime, the default setting for rinseback is No. If you select No and decide later to perform
rinseback, perform the following steps:
1 When the run targets screen appears, touch the End Run menu button. The end run tabs appear.
2 Touch the Rinseback tab.
3 Follow the instructions on the screen to proceed with rinseback.
Note: If you perform a custom prime, the system does not perform the step to divert the saline used to prime the tubing
set. The saline is removed from the set during the custom prime.
Warning: When performing a custom prime using red blood cells (RBC), ensure the unit contains a
sufficient number of RBC or RBC volume (RCV) to adequately fill the extracorporeal circuit of the tubing set.
An insufficient RCV may lead to an unintended decrease in patient hematocrit. The system will calculate the
necessary extracorporeal RCV based on the patient data entered (TBV and Hct), the tubing set and filler
used, if a blood/fluid warmer is used, and the type of procedure being performed.
Warning: Terumo BCT does not recommend the use of a diluted RBC unit to perform a custom prime. A
diluted unit may not contain a sufficient number of RBC or RBC volume (RCV) to compensate the patient for
the RCV required to adequately fill the extracorporeal circuit of the tubing set. If a diluted unit is used, the
patient may experience a decrease in hematocrit and may be unable to tolerate the procedure. The
attending physician should assess the patient’s condition and determine the appropriate RCV of the unit
used.
Note: To determine the number of RBC or RBC volume (RCV) in the unit you are using for the custom prime,
multiply the unit volume by the unit hematocrit. For example, a unit of 240 mL with a hematocrit of 60%
contains 144 mL of RCV (240 × 0.6 = 144).
2 To accept the recommendation, touch Yes. To decline the recommendation, touch No.
Note: To determine the number of RBC or RBC volume (RCV) in the unit you are using for the custom
prime, multiply the unit volume by the unit hematocrit. For example, a unit of 240 mL with a hematocrit of
60% contains 144 mL of RCV (240 × 0.6 = 144).
• Plasma
• Albumin
2 Enter the fluid data by touching the corresponding buttons on the screen:
• RBC unit Hct (%)
– This entry is available if you select RBC as the fluid type.
• Maximum inlet pump flow rate (mL/min)
– If you are using a filter, determine if the filter has a flow rate limit before you enter a maximum inlet
pump flow rate.
– Ensure that the access on the return line can accommodate the flow rate you entered.
• Volume (mL) of the custom prime fluid
6
– The patient will not receive the full benefit of the custom prime if the volume entered is less than
200 mL (Exchange Set or Collection Set) or 300 mL (IDL Set), plus the volume of any blood
warmer tubing on the return line.
3 Touch Confirm.
Note: Monitor the progress of the custom prime. If the actual volume in the container of custom prime fluid
is less than the volume you entered on the screen, you may need to stop the custom prime before it is
complete to avoid drawing air into the tubing set.
3 When the custom prime is complete, the screen appears instructing you to connect the patient lines.
Note: If you end the custom prime before the system has processed the recommended volume, an alarm
occurs reminding you that the patient will not receive the full benefit of the custom prime. Follow the
instructions on the screen to either resume or end the custom prime.
Note: The system uses 250 mL of saline for a saline rinse. If you intend to perform a saline rinse more than
once, you need additional saline.
• Empty bag of sufficient volume to hold the saline that is used for the saline rinse.
• Appropriate connector to connect the return line to the empty bag.
The inlet pump flow rate during a saline rinse depends on the tubing set you use. Ensure that the access to the bag
on the return line can accommodate the flow rate. The inlet pump flow rates for the tubing sets are as follows:
• Exchange Set: 120 mL/min
• Collection Set: 90 mL/min
• IDL Set: 90 mL/min
6 After the saline rinse is complete, perform the steps that appear on the screen:
• Close the inlet saline line.
• Clamp the return line.
7 Touch Continue. The screen instructing you to connect the patient lines appears.
8 If you intend to perform more than one saline rinse, proceed to the next section, “Repeating a saline rinse.”
Do not touch Confirm.
Exchange procedures
1 Select the line on the tubing set to which you want to connect the blood warmer. To use more than one blood
warmer, select both the return line and the replace line:
• To indicate a blood warmer on the return line, touch the return line button until Yes appears on the
button.
• To indicate a blood warmer on the replace line, touch the replace line button until Yes appears on the
button. Ensure that you connect the blood warmer to the replace line before you spike the replacement
fluid.
2 If you indicated a blood warmer on the return line, enter the volume of the blood warmer tubing set:
a. Touch the tubing set volume button. A data entry pad appears.
b. Enter the volume of the tubing set. The volume you entered appears on the button.
Supplies
Assemble the supplies listed on page 62 before you begin a procedure. You will also need the following additional
supplies:
• Replacement fluid prescribed by the patient’s physician
• Spectra Optia® Single-Needle Connector, if performing a TPE procedure using a single needle
Optional supplies:
• Filters for the replacement fluid
Options
Height:
• ft • 1 to 8
• in • 0 to 11
• cm • 30 to 244
Weight:
• lb • 5 to 500
• kg • 2 to 227
Hct (%) 10 to 70
Table 7-2: Data entry ranges for TPE procedure parameters (continued)
40 to 480
7
Plasma volumes exchanged 0.5 to 4
Table 7-2: Data entry ranges for TPE procedure parameters (continued)
Note: If the patient weighs less than 25 kg (approximately 55 lb), the system does not calculate a TBV. You
must calculate and enter the appropriate TBV for the patient.
Note: Only the color of the last value you changed remains yellow. The values you previously changed revert to
white.
2 When you are finished reviewing the run values, touch Confirm.
Note: If you select and confirm the single-needle option before you start the run, you may change your selection before
you prime the inlet line, the return line, and the single-needle connector. If you select and confirm the single-needle option
during the run, you cannot change your selection. You must complete the run using a single needle.
Priming the Inlet Line, the Return Line, and the Replace Line
Warning: When connecting a blood warmer tubing set to the return line, ensure that the tubing connection is
tight. Put the luer connection no higher than 20 in (50 cm) above the return access to prevent the possibility of air
entering the tubing.
Warning: If you are using a blood warmer on the return line, ensure that you completely prime the blood warmer
tubing set to remove all the air in the set before you connect the patient.
1 Follow the instructions on the screen to prime the inlet line and the return line. If you are using a blood
warmer on the replace line, follow the instructions under “Exchange Procedures: Using a Blood Warmer on
the Replace Line” on page 267 to connect and prime the blood warmer tubing set and to prime the replace
line. If you are not using a blood warmer or you are using a blood warmer on the return line, follow the
instructions on the screen.
2 Touch Confirm.
3 Follow the instructions on the screen to spike the replacement fluid container, to prime the replace line, and
to put the replace line into the replacement fluid detector.
4 Touch Continue. The screen appears with instructions for connecting the patient.
1 Follow the instructions on the screen to connect the patient and start the run.
2 Touch Start Run. The system begins drawing the patient’s blood into the tubing set. The main run screen
appears, and the system diverts approximately 40 mL of saline that was used to prime the tubing set into the
remove bag.
Note: If you performed a custom prime, the system does not perform the step to divert the saline. The saline was
removed from the set during the custom prime.
Algorithm control
The plasma of certain patients can cause extreme turbulence or platelet swirling to occur in the connector. If this
condition persists, the AIM system cannot effectively control the position of the interface. The system begins using
the entered hematocrit to calculate the plasma pump flow rate, and the algorithm control icon appears on the
screen in place of the interface image. After the interface position is stable for at least one minute, the AIM system
resumes control.
Replacement fluid
The type of replacement fluid currently in use appears on the button on this screen. Touch this button to change
the type of replacement fluid and then follow the instructions on the screens.
7
Note: If the fluid you use for the bolus is not saline, enter a flow rate that takes into account the percentage of
citrate in the fluid and that is in accordance with your local transfusion practices.
6 To begin the bolus, touch Start Bolus. The system delivers the bolus.
The screen displays the progress of the bolus. To cancel the bolus before delivery is complete, touch Cancel
Bolus.
7 When the bolus is complete, the system pauses. Touch Continue to resume the procedure.
1.0 63
1.5 78
2.0 86
2.5 92
3.0 95
Source:
George W. Buffaloe, et al., “Technical Considerations,” Therapeutic Plasma Exchange Disease Compendium, 1983,
Dau P (ed.).
Decreasing the Run Time After Converting the Access to a Single Needle
Converting the access to a single needle during the run causes an increase in the predicted run time for the
procedure. Consider the following alternatives for decreasing the predicted run time if a shorter run is necessary:
• Increase the inlet pump flow rate or increase the AC infusion rate.
Increasing these rates allows the system to process more blood in less time. Be aware that either option results
in a greater volume of AC delivered to the patient and increases the potential for the patient to experience a
citrate reaction.
• Increase the inlet:AC ratio.
This causes the inlet pump flow rate to increase. However, it decreases the system’s ability to manage
anticoagulation of the extracorporeal circuit and can result in clumping in the circuit. Monitor the run
carefully as you increase the inlet:AC ratio.
The increase in the run time can be more significant if you changed the inlet pump flow rate that the system had
established at the start of the run. After the conversion, the system resumes the run using the rate you entered
rather than using a rate that is optimal for a single access.
Supplies
Assemble the supplies listed on page 62 before you begin a procedure. You will also need the following additional
supplies:
• Secondary plasma device (plasma device), as prescribed
Warning: Before performing a therapeutic plasma exchange procedure with a secondary plasma device
(TPE-SPD procedure), carefully review the instructions for use provided by the manufacturer of the secondary
plasma device.
• Hemostats
• Extension tubing set to use to connect the plasma device to the Exchange Set
• Bag with a needle adapter to hold the treated plasma (treated plasma bag) and to attach to the outlet end of
the plasma device
Optional supplies:
• Bag to use for fluid waste diverted from the plasma device
• Connectors for connecting the treated plasma bag, the waste bag, or the tubing set to the plasma device. For
example:
• Two 3-way stopcocks or two Y-shaped connectors
• Male-to-male luer connector (optional)
Height:
• ft • 1 to 8
• in • 0 to 11
• cm • 30 to 244
Weight:
• lb • 5 to 500
• kg • 2 to 227
Hct (%) 10 to 70
Table 8-2: Data entry ranges for TPE-SPD procedure parameters (continued)
2 to 142
8
Main run Packing factor 4 to 20
Default: 20
(Packing factor can be changed only
during Semi-Automatic mode.)
Table 8-2: Data entry ranges for TPE-SPD procedure parameters (continued)
Note: If the patient weighs less than 25 kg (approximately 55 lb), the system does not calculate a TBV. You
must calculate and enter the appropriate TBV for the patient.
2 Touch Confirm. The data screen for the plasma device appears.
Note: Only the color of the last value you changed remains yellow. The values you previously changed revert to
white.
2 When you are finished reviewing the run values, touch Confirm.
1 Follow the instructions on the screen to connect a waste bag to the outlet end of the plasma device.
2 Touch Confirm.
3 Follow the instructions on the screen to spike the replace line into the saline container.
4 Touch Confirm. The screen appears instructing you to enter the data required for the prime and to prime the
plasma device.
5 Enter the volume of saline and the flow rate required for the prime.
6 Touch Start Prime. The system starts priming the plasma device.
• To pause the prime, touch Pause Prime.
• To restart the prime, touch Start Prime.
The screen displays the progress of the prime.
• Current Prime indicates the volume of saline that has been processed for the current prime.
• Total Prime indicates the total volume of saline that was processed for priming the plasma device during
the current procedure.
7 After the volume for the prime has been processed, perform one of the following steps:
• To process additional volume, repeat steps 5 and 6.
• If you are finished priming the plasma device, touch Prime Complete.
8 Follow the instructions on the screen to clamp the replace line, spike the second replace line into the treated
plasma bag, unclamp the second replace line, and connect the treated plasma bag to the outlet end of the
plasma device.
9 Touch Confirm.
Saline prime: No
1 If you intend to perform a prime divert, follow the instructions on the screen to connect a waste bag to the
outlet end of the plasma device.
2 Touch Confirm.
3 Follow the instructions on the screen to spike the second replace line into the treated plasma bag, and to
connect the treated plasma bag to the outlet end of the plasma device.
4 Touch Confirm.
Warning: If you are using a blood warmer on the return line, ensure that you completely prime the blood warmer
tubing set to remove all the air in the set before you connect the patient.
1 Follow the instructions on the screen to prime the inlet line, the return line, and the blood warmer tubing set,
if used.
2 Touch Confirm. The screen appears with instructions for connecting the patient and starting the run.
Note: If you performed a custom prime, the system does not perform the step to divert the saline. The saline was
removed from the set during the custom prime.
Note: If the fluid you use for the bolus is not saline, enter a flow rate that takes into account the percentage of
8
citrate in the fluid and that is in accordance with your local transfusion practices.
6 To begin the bolus, touch Start Bolus. The system delivers the bolus.
The screen displays the progress of the bolus. To cancel the bolus before delivery is complete, touch Cancel
Bolus.
7 When the bolus is complete, the system pauses. Touch Continue to resume the procedure.
Note: The replace pump balance decreases when you increase the volume to be maintained in the bag and
increases when you decrease the volume to be maintained in the bag.
2 When you finish adjusting the replace pump balance, touch Confirm.
Note: If you decide not to return the contents in the treated plasma bag to the patient, touch Skip Return to decline the
return.
Performing rinseback
When you are finished rinsing the plasma device, the screen that shows the status of rinseback appears, and
rinseback begins. To return the contents of the treated plasma bag to the patient during or after rinseback, follow
the instructions in “Returning the Contents of the Treated Plasma Bag to the Patient” on page 111.
a. Touch the pause button to pause the pumps. An alarm screen appears.
b. Clamp the line to the waste bag and unclamp the line to the treated plasma bag to allow the system to
begin filling the treated plasma bag.
c. Touch Continue to restart the pumps.
d. Once the system processes an addition 50 mL of plasma, clamp the replace line to the albumin container
and unclamp the second replace line to the treated plasma bag. The system begins returning the treated
plasma to the patient.
Supplies
Assemble the supplies listed on page 62 before you begin a procedure. You will also need the following additional
supplies:
• Replacement fluid prescribed by the patient’s physician
Optional supplies:
• Filters for the replacement fluid
RBCX
Blood warmer
Report Strobe
Run values
9
Options
Height:
• ft • 1 to 8
• in • 0 to 11
• cm • 30 to 244
Weight:
• lb • 5 to 500
• kg • 2 to 227
Hct (%) 10 to 80
Table 9-2: Data entry ranges for RBCX procedure parameters (continued)
FCR (%) 1 to 99
• Starting defective RBC (%) • 10 to 100
• Target defective RBC (%) • 1 to 99 (Depends on the starting
defective RBC entered.)
9
the current patient Hct if patient has
a low TBV.)
Table 9-2: Data entry ranges for RBCX procedure parameters (continued)
FCR (%) 1 to 99
Note: If the patient weighs less than 25 kg (approximately 55 lb), the system does not calculate a TBV. You
must calculate and enter the appropriate TBV for the patient.
Note: The system uses data you enter, including the Hct of the replacement fluid, to determine when the target
Hct has been attained. It is important that you enter an accurate Hct for the replacement fluid.
Exchange procedures
• Target Hct (%)
• One of the following targets:
• Replaced: Exchange (mL)
• FCR (%)
Depletion/Exchange procedures
• Minimum Hct (%)
• Target Hct (%)
• One of the following targets:
• Replaced: Exchange (mL)
• FCR (%)
Depletion procedures
• Target Hct (%)
Note: You may enter the starting and target defective RBC instead of the FCR, and the
system will calculate and display the FCR. To do this, touch the button for FCR on the screen
and then touch FCR on the data entry pad. The blood drop icon ( ) appears on the data
9
entry pad to allow you to enter the values for defective RBC.
• Starting defective RBC (%) Percentage of defective RBC in the patient’s blood at the start of the procedure
• Target defective RBC (%) Percentage of defective RBC in the patient’s blood at the end of the procedure
Target Hct (%) Desired patient Hct at the end of the procedure
Replaced (mL): Exchange Volume of replacement fluid that is required to complete the exchange procedure. If you
enter a volume here, the system calculates and displays the FCR.
Perform the following steps to enter and confirm the run targets and run values:
1 Touch the button on the screen that corresponds to the target value you want to enter. The data entry pad
appears.
2 Enter the target value.
3 Review the run values that appear on the screen and confirm that they are correct. A black frame appears
around the button of the primary run target.
Note: During depletion/exchange procedures, the system displays the run time for the depletion in parentheses
above the total run time for the depletion/exchange.
If you change a value, the color of the value on the button changes from white to yellow. Values that were
affected by a change appear with a yellow arrow. The arrow points up or down to indicate an increase or
decrease in the value as a result of the change.
Note: Only the color of the last value you changed remains yellow. The values you previously changed revert to
white.
4 When you are finished entering and confirming the run targets and the run values, touch Confirm.
Priming the Inlet Line, the Return Line, and the Replace Line
Warning: When connecting a blood warmer tubing set to the return line, ensure that the tubing connection is
tight. Put the luer connection no higher than 20 in (50 cm) above the return access to prevent the possibility of air
entering the tubing.
Warning: If you are using a blood warmer on the return line, ensure that you completely prime the blood warmer
tubing set to remove all the air in the set before you connect the patient.
1 Follow the instructions on the screen to prime the inlet line and the return line. If you are using a blood
warmer on the replace line, follow the instructions under “Exchange Procedures: Using a Blood Warmer on
the Replace Line” on page 267 to connect and prime the blood warmer tubing set and to prime the replace
line. If you are not using a blood warmer or you are using a blood warmer on the return line, follow the
instructions on the screen.
2 Touch Confirm.
3 Follow the instructions on the screen to spike the replacement fluid container, to prime the replace line, and
to put the replace line into the replacement fluid detector.
4 Touch Continue. The screen appears with instructions for connecting the patient.
1 Follow the instructions on the screen to connect the patient and start the run.
2 Touch Start Run. The system begins drawing the patient’s blood into the tubing set. The main run screen
appears, and the system diverts approximately 40 mL of saline that was used to prime the tubing set into the
remove bag.
Note: If you performed a custom prime, the system does not perform the step to divert the saline. The saline was
removed from the set during the custom prime.
Replacement fluid
The type of replacement fluid currently in use appears on the button on this screen. Touch this button to change
the type of replacement fluid and then follow the instructions on the screens.
Patient Hct
The system uses the patient Hct and the replacement fluid Hct that was entered before the start of the run to
predict the current patient Hct displayed on the screen. The system does not take into account RBC that were
released from the spleen when predicting this value.
Note: If the fluid you use for the bolus is not saline, enter a flow rate that takes into account the percentage of
citrate in the fluid and that is in accordance with your local transfusion practices.
6 To begin the bolus, touch Start Bolus. The system delivers the bolus.
9
The screen displays the progress of the bolus. To cancel the bolus before delivery is complete, touch Cancel
Bolus.
7 When the bolus is complete, the system pauses. Touch Continue to resume the procedure.
6 Enter the current patient Hct. A screen appears to confirm the change to the Hct.
7 Follow the instructions on the screen to verify and confirm the change. The run values screen appears.
8 Review the run values.
9 Touch Confirm.
10 Return to the alarm screen and touch Continue to restart the pumps and resume the procedure.
Accumulation phase
During the accumulation phase, the system pumps the patient’s blood into the tubing set and spins the centrifuge
at the speed required to target the optimal (default) packing factor of 20. The AIM system adjusts the plasma pump
flow rate to control the concentration of cells that flow through the collect port (based on the collection
preference), and the collect pump pumps the MNC and platelets from the connector into the chamber. The
chamber fills with MNC and the platelets flow through the chamber and are returned to the patient.
The plasma pump also pumps plasma out of the channel and either into the reservoir, or into the plasma bag or the
collection bag if plasma collection is targeted. The red blood cells (RBC) are pushed out of the channel and into the
reservoir, where they combine with the plasma for return to the patient.
Collection phase
A collection phase occurs at the beginning of the second and all subsequent accumulation phases. The collection
phase begins once the system predicts that the chamber is at least 50% full of MNC, and the RBC detector detects
RBC in the collect line. When the phase begins, the system stops the plasma pump to lower the interface, stops the
collect pump, and decreases the centrifuge speed. It then restarts the collect pump and moves the collect valve into
the collect position. The collect pump pumps plasma through the chamber to flush the chamber contents into the
collection bag.
After the system flushes the chamber, it stops the collect pump and increases the centrifuge speed. It then restarts
the plasma pump and the collect pump to start the chase. During the chase, the system displaces the cells remaining
in the collect line between the chamber and the collect valve into the collection bag before it moves the collect valve
into the return position to end the collection phase.
Supplies
Assemble the supplies listed on page 62 before you begin a procedure.
Table 10-1: Menu buttons and tabs on MNC collection procedure screens
AC Options
Advanced control
10
Table 10-2: Data entry ranges for MNC collection procedure parameters
Height
• ft • 1 to 8
• in • 0 to 11
• cm • 30 to 244
Weight
• lb • 5 to 500
• kg • 2 to 227
Hct (%) 10 to 70
Table 10-2: Data entry ranges for MNC collection procedure parameters (continued)
TBV processed 1 to 10
Table 10-2: Data entry ranges for MNC collection procedure parameters (continued)
Run targets Plasma bag (mL): Target Depends on the volume of plasma to
be collected into the collection bag.
(Total volume of plasma collected
cannot exceed 100% of the patient’s
total plasma volume, and cannot
cause the target or actual fluid
balance to be less than 75% of the
patient’s TBV.)
TBV processed 1 to 10
Table 10-2: Data entry ranges for MNC collection procedure parameters (continued)
10
Note: When you are required to enter numerical data, the system displays a data entry pad for entering the data. The
acceptable numerical range appears on the data entry pad.
Note: If the patient weighs less than 25 kg (approximately 55 lb), the system does not calculate a TBV. You
must calculate and enter the appropriate TBV for the patient.
If you change a value, the color of the value on the button changes from white to yellow. Values that were
affected by a change appear with a yellow arrow. The arrow points up or down to indicate an increase or
decrease in the value as a result of the change.
Note: Only the color of the last value you changed remains yellow. The values you previously changed revert to
white.
2 When you are finished reviewing the run values, touch Confirm.
Warning: If you are using a blood warmer on the return line, ensure that you completely prime the blood warmer
tubing set to remove all the air in the set before you connect the patient.
1 Follow the instructions on the screen to prime the inlet line and the return line. If you are using a blood
warmer on the return line, follow the instructions on the screen to connect and prime the blood warmer
tubing set.
2 Touch Confirm. The screen appears with instructions for connecting the patient and starting the run.
1 Follow the instructions below and on the screen to connect the patient.
• If you are performing a peripheral venipuncture, see “Collection Set and IDL Set: Additional Instructions
for Use” on page 269 for instructions on using the needle protector.
• If you are performing a peripheral venipuncture and want to use the diversion bag on the inlet line, see
“Using the Diversion Bag to Collect a Sample From a Venipuncture” on page 269 for instructions.
2 Touch Start Run. The system begins drawing the patient’s blood into the tubing set. The main run screen
appears, and the system diverts approximately 40 mL of saline that was used to prime the tubing set into the
saline container.
10
Note: If you performed a custom prime, the system does not perform the step to divert the saline. The saline was
removed from the set during the custom prime.
Collection preference
The collection preference is a reference number that the AIM system uses to determine the concentration of cells
that should flow through the collect port. The collection preference can affect the type of cells that fill the chamber
and how quickly the chamber fills.
AIM system and the concentration of cells flowing through the collect port
The AIM system cannot identify the type of cells that flow through the collect port; it can only control the
concentration of cells. It determines the concentration by evaluating how much light penetrates the contents in the
collect port as follows:
• High collection preference: More light can penetrate the contents. The concentration is low and the color in
the collect port looks light.
• Low collection preference: Less light can penetrate the contents. The concentration is high and the color in
the collect port looks dark.
The system then uses this information to adjust the plasma pump flow rate and achieve the specified collection
preference.
Trend graph
The trend graph shows the status of the current accumulation phase. It represents an area of the buffy coat that is in
the connector. The horizontal black line on the graph indicates the current collection preference. The green
diamonds indicate the concentration of cells flowing into the chamber as compared to the collection preference.
If the system is unable to collect cells at the target collection preference, the green diamonds could appear above or
below the black line. As long as the diamonds appear in a controlled path within 20 units either above or below the
line, the run is progressing as intended.
10
Flush chamber
To immediately change the position of the collect valve and flush the chamber, perform one of the following steps:
• To return the contents of the chamber to the patient, touch the button for return to patient and then touch
Apply. The collect pump pumps a volume of plasma equal to 1.5 multiplied by the flush volume through the
chamber to flush the contents of the chamber to the patient. If you return the contents of the chamber to the
patient, the system does not display the inlet volume that was processed before you initiated the return on the
graph on the collection status screen.
• To initiate a collection phase and flush the contents of the chamber into the collection bag, touch the button
for collect into bag and then touch Apply.
Clumping in connector
To address clumping in the connector, touch Decrease Inlet:AC Ratio. The system decreases the inlet:AC ratio to
8:1. After 100 mL of inlet volume has been processed, a screen appears with instructions for ensuring that the
clumping is resolved and for resuming the procedure. For additional information about anticoagulation in the
tubing set, see “Managing Anticoagulation of the Extracorporeal Circuit” on page 221.
Chamber
The configured volumes for the chamber flush and the chamber chase appear on the buttons. You can adjust the
volumes at any time during the run. Any changes to the volumes take immediate effect and apply to the current
procedure only.
10
• Increase the inlet:AC ratio. This causes the inlet pump flow rate to increase. However, it decreases the system’s
ability to manage anticoagulation of the extracorporeal circuit and can result in clumping in the circuit.
Monitor the run carefully as you increase the inlet:AC ratio.
• Decrease the target run time. Make the run time the run target by entering the desired time on the run values
or run targets screen. This ensures that the run ends when required.
Transferring Plasma from the Plasma Bag into the Collection Bag
Caution: When transferring plasma from the plasma bag to the collection bag during an MNC collection procedure, you
must put the collection bag lower than the plasma bag as indicated in the instructions on the screen. Otherwise, cells in the
collection bag can flow into the plasma bag.
The system allows you to transfer plasma from the plasma bag into the collection bag during the run except during
a collection phase. To transfer plasma during the run, perform the following steps:
1 Touch the End Run menu button. The end run tabs appear.
2 Touch the Plasma tab.
3 Follow the instructions on the screen to put the collection bag lower than the plasma bag.
4 Touch Start Transfer. The plasma valve moves into the neutral position and the RBC valve moves into the
collect position.
5 Allow the plasma to flow from the plasma bag into the collection bag.
6 When the transfer is complete, touch Resume Run, or if the run targets have been attained and you want to
end the run, touch End Transfer. The plasma and RBC valves move back to the return position. The not
equal icon ( ) appears next to the plasma bag volume and the collection bag volume on the screens
indicating that the current volumes may be different from the displayed volumes.
Note: If you obtained a product sample before you transferred plasma into the collection bag, consider taking a new
sample. The additional volume you added to the collection bag could affect the cell concentration.
10
Supplies
Assemble the supplies listed on page 62 before you begin a procedure.
CMNC Strobe
AC Options
Height:
• ft • 1 to 8
• in • 0 to 11
• cm • 30 to 244
Weight:
• lb • 5 to 500
• kg • 2 to 227
Hct (%) 10 to 70
Table 11-2: Data entry ranges for CMNC procedure parameters (continued)
Screen
Volume (mL)
Parameter
100 to 400
Range
TBV processed 1 to 10
Plasma volume: Target (mL) in plasma bag 0 to the patient’s plasma volume
minus the current collect volume and
the current volume of plasma in the
collection bag
(Sum of the total plasma volume and
the collect volume cannot exceed
100% of the patient’s total plasma
volume.)
Table 11-2: Data entry ranges for CMNC procedure parameters (continued)
TBV processed 1 to 10
Note: If the patient weighs less than 25 kg (approximately 55 lb), the system does not calculate a TBV. You
must calculate and enter the appropriate TBV for the patient.
Note: Only the color of the last value you changed remains yellow. The values you previously changed revert to
white.
2 When you are finished reviewing the run values, touch Confirm.
Collecting plasma
To collect the plasma, the system stops the collect pump, increases the centrifuge speed and decreases the inlet
pump flow rate to 60 mL/min, if necessary, to increase the packing factor to at least 14 and to reduce the number
of platelets flowing through the plasma port. Once the target packing factor is achieved, the system decreases the
plasma pump flow rate, which lowers the interface position. The system then increases the plasma pump flow rate
and once any remaining platelets have been cleared from the plasma line, the system moves the plasma valve into
the collect position and begins collecting plasma.
If you configured the procedure to collect plasma at the beginning of the run and you increase the target plasma
volume during the run, a screen appears with instructions for indicating whether the additional volume should be
collected immediately (now) or at the end of the run. Follow the instructions on the screen to indicate your
preference and resume the run.
1 Follow the instructions on the screen to prime the inlet line and the return line. If you are using a blood
warmer on the return line, follow the instructions on the screen to connect and prime the blood warmer
tubing set.
2 Touch Confirm. The screen appears with instructions for connecting the patient and starting the run.
1 Follow the instructions below and on the screen to connect the patient.
• If you are performing a peripheral venipuncture, see “Collection Set and IDL Set: Additional Instructions
for Use” on page 269 for instructions on using the needle protector.
• If you are performing a peripheral venipuncture and want to use the diversion bag on the inlet line, see
“Using the Diversion Bag to Collect a Sample From a Venipuncture” on page 269 for instructions.
2 Touch Start Run. The system begins drawing the patient’s blood into the tubing set. The main run screen
appears, and the system diverts approximately 40 mL of saline that was used to prime the tubing set into the
saline container.
Note: If you performed a custom prime, the system does not perform the step to divert the saline. The saline was
removed from the set during the custom prime.
Collection preference
The collection preference is a reference number that the system uses to adjust the plasma pump flow rate, which
affects the concentration of cells that flow through the collect port. You can use the up and down arrows to change
the collection preference during the run to accommodate the conditions of the patient’s blood and achieve the
desired outcome of the procedure.
The default collection preference for a CMNC procedure is 50. While establishing the initial interface or while
re-establishing the interface after a pump pause or a centrifuge stop, the system targets a higher preference to avoid
collecting non-target cells before the interface is stable. The collection preference that the system targets depends
on whether or not you change the preference before the interface is established.
• If you do not change the collection preference, the system targets a collection preference of 60.
• If you change the collection preference, the system targets a collection preference that is about 10 points
higher than the number that you selected, but is not less than a preference of 20.
Once the interface is established, the system gradually decreases the collection preference either to the default or to
the number that you selected. For more information about optimizing the collection preference during the run, see
“Optimizing the Collection Preference” on page 158.
Trend graph
The trend graph represents an area of the buffy coat that is in the connector. The horizontal black line on the graph
indicates the current collection preference. The green diamonds indicate the concentration of cells flowing through
the collect port as compared to the collection preference.
If the system is unable to collect cells at the target collection preference, the green diamonds could appear above or
below the black line. As long as the diamonds appear in a controlled path within 20 units either above or below the
line, the run is progressing as intended.
• To direct the flow of cells from the collect line back to the patient, touch the return to patient button and then
touch Apply. The collect valve moves into the return position and the system begins pumping the cells into
the reservoir for return to the patient.
Note: If you touch the return to patient button, the system operates in Caution status because cells are not
being collected. The collect valve stays in the return position until you touch the collect into bag button.
11
• To direct the flow of cells in the collect line into the collection bag, touch the collect into bag button and then
touch Apply. The collect valve moves into the collect position, and the system begins pumping the cells into
the collection bag.
Monitoring the contents in the collect line and adjusting the color
Monitor the collect line where it exits the centrifuge below the cassette, and use the collection preference to adjust
the color of the contents in the line. To accurately evaluate the color, you should allow the collect pump to process
1 mL to 2 mL of volume before making an additional adjustment.
The Collection Preference Tool can help you evaluate which color is appropriate for the procedure. If the contents
in the line look either too light or too dark, consider making adjustments to the run according to the following
guidelines:
• Color is too light:
• Decrease the collection preference. This increases the concentration of cells that flow through the collect
port.
• Reset the collect pump flow rate to the default flow rate. When the collect pump flow rate is too slow, cells
can accumulate in the connector, making it difficult to collect cells that are deeper in the buffy coat.
• Color is too dark:
• Increase the collection preference. This decreases the concentration of cells that flow through the collect
port.
Note: If the patient has a high WBC count, consider using a collect pump flow rate of 1.0 mL/min to 1.5 mL/min,
especially if you are using a high inlet flow rate.
• Decrease the collection preference. The interface may not be high enough to allow the system to collect the
buffy coat.
Supplies
Assemble the supplies listed on page 62 before you begin a procedure.
Using HES
HES is a sedimenting agent that causes RBC to separate more efficiently from granulocytes during a PMN
collection procedure. If you choose to use HES, you must select Yes for HES on the PMN configuration screen or
on the options screen. “HES: Yes” appears on the main run screen as a reminder of your selection. When using
HES, you must add trisodium citrate to the HES for use as the anticoagulant. The default packing factor when
HES is used is 1.6.
Using ACD-A
If you choose to use ACD-A, you must select No for HES on the PMN configuration screen or on the options
screen. “HES: No” appears on the main run screen as a reminder of your selection. Also refer to “Optimizing a
PMN Collection Procedure When Using ACD-A” on page 173 for information about adjustments you can make
to optimize the run. The default packing factor when ACD-A is used is 4.5.
12
Table 12-1: Menu buttons and tabs on PMN collection procedure screens
PMN Strobe
Options
Height:
• ft • 1 to 8
• in • 0 to 11
• cm • 30 to 244
Weight:
• lb • 5 to 500
• kg • 2 to 227
Hct (%) 10 to 70
HES • Yes
Selection determines the default packing factor. • No
• Yes: Default packing factor is 1.6
• No: Default packing factor is 4.5
Table 12-2: Data entry ranges for PMN collection procedures (continued)
Plasma volume: Target (mL) in plasma bag 0 to the patient’s plasma volume
minus the current collect volume and
the current volume of plasma in the
collection bag
(Sum of the total plasma volume and
the collect volume cannot exceed
100% of the patient’s total plasma
volume.)
Table 12-2: Data entry ranges for PMN collection procedures (continued)
Note: When you are required to enter numerical data, the system displays a data entry pad for entering the data. The
acceptable numerical range appears on the data entry pad.
Note: If the patient weighs less than 25 kg (approximately 55 lb), the system does not calculate a TBV. You
must calculate and enter the appropriate TBV for the patient.
Note: Only the color of the last value you changed remains yellow. The values you previously changed revert to
white.
2 When you are finished reviewing the run values, touch Confirm.
Collecting plasma
To collect the plasma, the system stops the collect pump, increases the centrifuge speed and decreases the inlet
pump flow rate to 60 mL/min, if necessary, to increase the packing factor to at least 14.0 and to reduce the number
of platelets flowing through the plasma port. Once the target packing factor is achieved, the system decreases the
plasma pump flow rate, which lowers the interface position. The system then increases the plasma pump flow rate
and once any remaining platelets have been cleared from the plasma line, the system moves the plasma valve into
the collect position and begins collecting plasma.
Warning: If you are using a blood warmer on the return line, ensure that you completely prime the blood warmer
tubing set to remove all the air in the set before you connect the patient.
1 Follow the instructions on the screen to prime the inlet line and the return line. If you are using a blood
warmer on the return line, follow the instructions on the screen to connect and prime the blood warmer
tubing set.
2 Touch Confirm. The screen appears with instructions for connecting the patient and starting the run.
1 Follow the instructions below and on the screen to connect the patient.
• If you are performing a peripheral venipuncture, see “Collection Set and IDL Set: Additional Instructions
for Use” on page 269 for instructions on using the needle protector.
• If you are performing a peripheral venipuncture and want to use the diversion bag on the inlet line, see
“Using the Diversion Bag to Collect a Sample From a Venipuncture” on page 269 for instructions.
2 Touch Start Run. The system begins drawing the patient’s blood into the tubing set. The main run screen
appears, and the system diverts approximately 40 mL of saline that was used to prime the tubing set into the
saline container.
Note: If you performed a custom prime, the system does not perform the step to divert the saline. The saline was
removed from the set during the custom prime.
Collection preference
The collection preference is a reference number that the system uses to adjust the plasma pump flow rate, which
affects the concentration of cells that flow through the collect port. You can use the up and down arrows to change
the collection preference during the run to accommodate the conditions of the patient’s blood and achieve the
desired outcome of the procedure.
The default collection preference for a PMN collection procedure is 60. While establishing the initial interface or
while re-establishing the interface after a pump pause or a centrifuge stop, the system targets a higher preference to
avoid collecting non-target cells before the interface is stable. The collection preference that the system targets
depends on whether or not you change the preference before the interface is established.
• If you do not change the collection preference, the system targets a collection preference of 70.
• If you change the collection preference, the system targets a collection preference that is about 10 points
higher than the number that you selected, but is not less than a preference of 65.
Once the interface is established, the system gradually decreases the collection preference either to the default or to
the number that you selected. For more information about optimizing the collection preference during the run, see
“Optimizing the Collection Preference” on page 173.
Trend graph
The trend graph shows the status of the collection. It represents an area of the buffy coat that is in the connector.
The horizontal black line on the graph indicates the current collection preference. The green diamonds indicate the
concentration of cells flowing through the collect port as compared to the collection preference.
If the system is unable to collect cells at the target collection preference, the green diamonds could appear above or
below the black line. As long as the diamonds appear in a controlled path within 20 units either above or below the
line, the run is progressing as intended.
• To direct the flow of cells from the collect line back to the patient, touch the return to patient button and then
touch Apply. The collect valve moves into the return position and the system begins pumping the cells into
the reservoir for return to the patient.
Note: If you touch the Return to Patient button, the system operates in Caution status because cells are not
being collected. The collect valve stays in the return position until you touch the Collect into Bag button.
• To direct the flow of cells in the collect line into the collection bag, touch the collect into bag button and then
touch Apply. The collect valve moves into the collect position and the system begins pumping the cells into
the collection bag.
Monitoring the contents in the collect line and adjusting the color
Monitor the collect line where it exits the centrifuge below the cassette, and use the collection preference to adjust
the color of the contents in the line. To accurately evaluate the color, you should allow the collect pump to process
1 mL to 2 mL of volume before making an additional adjustment.
The Collection Preference Tool can help you evaluate which color is appropriate for the procedure. If the contents
in the line look either too light or too dark, consider making adjustments to the run according to the following
guidelines:
If you decrease the run time and intend to collect plasma at the end of the run, make sure you review the
target plasma volume on the run values screen and confirm that it is still appropriate. The system prioritizes
collection of the target collect volume over the target plasma volume. This means that if you decrease the run
time, the system will decrease the target plasma volume. You can increase the target plasma volume if it is too
low, but be aware that the collect volume will decrease as a result.
Supplies
Assemble the supplies listed on page 62 before you begin a procedure. You will also need the following additional
supplies:
• Replacement fluid prescribed by the patient’s physician
Note: Using a filter for the replacement fluid during a WBCD or a PLTD procedure is not recommended. A filter can
slow the flow of the replacement fluid into the reservoir and ultimately to the patient.
Using ACD-A
To indicate the use of ACD-A, you must select No for HES on the WBCD configuration screen or on the options
screen. “HES: No” appears on the main run screen as a reminder of your selection. The default packing factor when
ACD-A is used is 4.5.
Using HES
To indicate the use of HES, you must select Yes for HES on the WBCD configuration screen or on the options
screen. “HES: Yes” appears on the main run screen as a reminder of your selection.When using HES, you must add
trisodium citrate to the HES for use as the anticoagulant. The default packing factor when HES is used is 1.6.
13
Table 13-1: Menu buttons and tabs on WBCD and PLTD procedure screens
Options
Table 13-2: Data entry ranges for WBCD and PLTD procedures
Height:
• ft • 1 to 8
• in • 0 to 11
• cm • 30 to 244
Weight:
• lb • 5 to 500
• kg • 2 to 227
Hct (%) 10 to 70
HES • Yes
Selection determines the default packing factor. • No
• Yes: Default packing factor is 1.6
• No: Default packing factor is 4.5
Table 13-2: Data entry ranges for WBCD and PLTD procedures (continued)
Replacement fluid:
• Fluid type • No fluid
• Plasma
• Saline/Albumin
• RBC
• Custom
Table 13-2: Data entry ranges for WBCD and PLTD procedures (continued)
Note: When you are required to enter numerical data, the system displays a data entry pad for entering the data. The
acceptable numerical range appears on the data entry pad.
Note: If the patient weighs less than 25 kg (approximately 55 lb), the system does not calculate a TBV. You
must calculate and enter the appropriate TBV for the patient.
Reviewing and Confirming the Run Values and the Fluid Data
1 Review the run values that appear on the screen and confirm that they are correct. The run targets for a
WBCD procedure or a PLTD procedure are listed below. A black frame appears around the button of the
primary run target.
• Whole blood processed (mL)
• TBV processed
• Run time (min)
• Collect volume: Target (mL)
If you change a value, the color of the value on the button changes from white to yellow. Values that were
affected by a change appear with a yellow arrow. The arrow points up or down to indicate an increase or
decrease in the value as a result of the change.
Note: Only the color of the last value you changed remains yellow. The values you previously changed revert to
white.
2 Review the target fluid balance and the replacement fluid data. To select replacement fluid to use during the
run and to change the target fluid balance, proceed to “Entering and changing the fluid data” below.
Note: You must use replacement fluid if the data you entered results in a target fluid balance of less than 70% of the
patient’s TBV.
3 When you are finished reviewing the run values and the fluid data, touch Confirm.
Note: If you enter the target fluid balance as a percentage, the system calculates and displays the
corresponding volume on the volume button. The reverse applies if you enter the target fluid balance as a volume.
Warning: If you are using a blood warmer on the return line, ensure that you completely prime the blood warmer
tubing set to remove all the air in the set before you connect the patient.
1 Follow the instructions on the screen to prime the inlet line and the return line. If you are using a blood
warmer on the return line, follow the instructions on the screen to connect and prime the blood warmer
tubing set.
13
2 Touch Confirm. The screen appears with instructions for connecting the patient and starting the run.
1 Follow the instructions below and on the screen to connect the patient.
• If you are performing a peripheral venipuncture, see “Collection Set and IDL Set: Additional Instructions
for Use” on page 269 for instructions on using the needle protector.
• If you are performing a peripheral venipuncture and want to use the diversion bag on the inlet line, see
“Using the Diversion Bag to Collect a Sample From a Venipuncture” on page 269 for instructions.
2 Touch Start Run. The system begins drawing the patient’s blood into the tubing set. The main run screen
appears and the system diverts approximately 40 mL of saline that was used to prime the tubing set into the
saline container.
Note: If you performed a custom prime, the system does not perform the step to divert the saline. The saline was
removed from the set during the custom prime.
Collection preference
The collection preference is a reference number that the system uses to adjust the plasma pump flow rate, which
affects the concentration of cells that flow through the collect port. You can use the up and down arrows to change
the collection preference during the run to accommodate the conditions of the patient’s blood and achieve the
desired outcome of the procedure.
The default collection preference for WBCD and PLTD procedures is 75. While establishing the initial interface or
while re-establishing the interface after a pump pause or a centrifuge stop, the system targets a higher preference to
avoid collecting non-target cells before the interface is stable. The collection preference that the system targets
depends on whether or not you change the preference before the interface is established.
• If you do not change the collection preference, the system targets a collection preference of 85.
• If you change the collection preference, the system targets a collection preference that is about 10 points
higher than the number that you selected, but is not less than a preference of 65.
Once the interface is established, the system gradually decreases the collection preference either to the default or to
the number that you selected. For more information about optimizing the collection preference during the run, see
“Optimizing the Collection Preference” on page 190.
Trend graph
The trend graph represents an area of the buffy coat that is in the connector. The horizontal black line on the graph
indicates the current collection preference. The green diamonds indicate the concentration of cells flowing through
the collect port as compared to the collection preference.
If the system is unable to collect cells at the target collection preference, the green diamonds could appear above or
below the black line. As long as the diamonds appear in a controlled path within 20 units either above or below the
line, the run is progressing as intended.
• To direct the flow of cells from the collect line back to the patient, touch the return to patient button and then
touch Apply. The collect valve moves into the return position, and the system begins pumping the cells into
the reservoir for return to the patient.
Note: If you touch the return to patient button, the system operates in Caution status because cells are not
being collected. The collect valve stays in the return position until you touch the collect into bag button.
• To direct the flow of cells in the collect line into the collection bag, touch the collect into bag button and then
touch Apply. The collect valve moves into the collect position and the system begins pumping the cells into
the collection bag.
Monitoring the contents in the collect line and adjusting the color
Monitor the collect line where it exits the centrifuge below the cassette, and use the collection preference to adjust
the color of the contents in the line. To accurately evaluate the color, you should allow the collect pump to process
1 mL to 2 mL of volume before making an additional adjustment.
The Collection Preference Tool can help you evaluate which color is appropriate for the procedure. If the contents
in the line look either too light or too dark, consider making adjustments to the run according to the following
guidelines:
• Color is too light:
• Decrease the collection preference. This increases the concentration of cells that flow through the collect
port.
• Verify that you have entered an accurate WBC count or platelet count.
13
• Reset the collect pump flow rate to the default flow rate. When the collect pump flow rate is too slow, cells
can accumulate in the connector, making it difficult to collect cells that are deeper in the buffy coat.
• Color is too dark:
• Increase the collection preference. This decreases the concentration of cells that flow through the collect
port.
Supplies
Assemble the supplies listed on page 62 before you begin a procedure. You will also need the following additional
supplies:
• Spectra Optia® BMP Accessory Set
Optional supplies:
• Blood administration set with a male luer connector and the appropriate size filter for filtering clots, bone
chips, and debris from the bone marrow
• Sterile tubing welder with the appropriate replacement wafers
5 Add the ACD-A volume from step 4 to the BM bag and mix the contents of the bag thoroughly.
6 Calculate the total BM volume (BMV) to enter on the BM data screen during the procedure:
BM volume (mL) + ACD-A (mL) = BMV (mL)
7 Measure the hematocrit (Hct) of the bone marrow in the BM bag. This is the Hct you enter on the BM data
screen during the procedure.
9 Remove the administration line and the BM bag. Discard the line and the bag according to your facility’s
standard operating procedure.
Figure 14-1: Correct location to seal the administration line on the BMP Accessory Set
Preparing the Tubing Set for Plasma Collection When Using an IDL Set With Catalog
Number 10300
If you configured the system to collect plasma and you are using an IDL Set with the catalog number 10300, a
screen appears before you load the tubing set instructing you to prepare the tubing set for plasma collection.
Unpack the tubing set, and then either spike the plasma bag on the replace line of the tubing set or use a sterile
tubing welder to connect the plasma bag to the replace line. Using a sterile tubing welder to connect the plasma bag
helps to maintain a functionally closed system.
Using a sterile tubing welder to connect the plasma bag to the replace line
Connect the plasma bag line to the replace line between the frangible connector and the cassette of the tubing set.
Follow the manufacturer’s instructions for using the sterile tubing welder.
Report
BMP
Report Strobe
Run values
Run targets
14
Options
Hct (%) 10 to 50
BM cycles 4 to 10
(Minimum number of cycles depends
on the volume of RBC in the BMP
bag.)
BM cycles 4 to 10
(Minimum number of cycles depends
on the volume of RBC in the BMP
bag.)
Rinseback
Plasma bag (mL)
2 to 100
Default: inlet flow rate that was in
14
use when the run ended or
100 mL/min, whichever is slower
Note: When you are required to enter numerical data, the system displays a data entry pad for entering the data. The
acceptable numerical range appears on the data entry pad.
Entering BM Data
1 Touch the buttons on the screen to enter the following information:
• BMV (mL)
• Hematocrit (Hct)
The BMP bag must contain at least 125 mL of RBC. The tubing set channel must contain enough RBC for
the system to establish an interface that is high enough for cells to be pumped into the collect line. If the bag
contains less than 125 mL, the system displays instructions for either increasing the RBC volume or
discontinuing the procedure.
2 Touch Confirm. The run values screen appears.
Note: Only the color of the last value you changed remains yellow. The values you previously changed revert to
white.
2 When you are finished reviewing the run values, touch Confirm.
Note: You must hang the BMP bag on the back hooks of the IV pole. The front hooks cannot properly
accommodate the bag.
2 Touch Start Run. The system begins drawing the bone marrow into the tubing set. The main run screen
appears, and the system diverts approximately 40 mL of saline used to prime the tubing set into the saline
container.
Collection preference
The collection preference is a reference number that the system uses to adjust the plasma pump flow rate, which
affects the concentration of cells that flow through the collect port. You can use the up and down arrows to change
the collection preference during the run to accommodate the conditions of the bone marrow and achieve the
desired outcome of the procedure.
The default collection preference for a BMP procedure is 50. While establishing the initial interface or while
re-establishing the interface after a pump pause or a centrifuge stop, the system targets a higher preference to avoid
collecting non-target cells before the interface is stable. The collection preference that the system targets depends
on whether or not you change the preference before the interface is established.
• If you do not change the collection preference, the system targets a collection preference of 70.
• If you change the collection preference, the system targets a collection preference that is about 10 points
higher than the number that you selected, but is not less than a preference of 70.
Once the interface is established, the system gradually decreases the collection preference either to the default or to
the number that you selected. For more information about optimizing the collection preference during the run, see
“Optimizing the Collection Preference” on page 204.
Trend graph
The trend graph represents an area of the buffy coat that is in the connector. The horizontal black line on the graph
indicates the current collection preference. The green diamonds indicate the concentration of cells flowing through
the collect port as compared to the collection preference.
If the system is unable to collect cells at the target collection preference, the green diamonds could appear above or
below the black line. As long as the diamonds appear in a controlled path within 20 units either above or below the
line, the run is progressing as intended.
Note: If you touch the return to BMP bag button, the system operates in Caution status because cells are not
being collected. The collect valve stays in the return position until you touch the collect into bag button.
• To direct the flow of cells in the collect line into the collection bag, touch the collect into bag button and then
touch Apply. The collect valve moves into the collect position and the system begins pumping the cells into
the collection bag. 14
Monitoring the contents in the collect line and adjusting the color
Monitor the collect line where it exits the centrifuge below the cassette, and use the collection preference to adjust
the color of the contents in the line.
The Collection Preference Tool can help you evaluate which color is appropriate for the procedure. If the contents
in the line look either too light or too dark, consider changing the collection preference according to the following
guidelines:
• If the color is too light, decrease the collection preference. This increases the concentration of cells that flow
through the collect port.
• If the color is too dark, increase the collection preference. This decreases the concentration of cells that flow
through the collect port.
If you decide to end the run before a run target is attained, perform the following steps:
1 Touch the End Run menu button.
2 Choose one of the following options:
• To perform rinseback, touch the Rinseback tab.
• To skip rinseback, touch the Disconnect tab.
3 Follow the instructions on the screens to complete the procedure and disconnect the patient.
5 Touch Continue. The screen that shows the status of rinseback appears.
6 When rinseback is complete, follow the instructions under “Completing the Procedure” to disconnect the
patient and complete the procedure.
15
Warning: Do not seal the tubing within 8 cm (3 in) of the needle, or you may cause a burn at the needle entry
point.
Warning: Do not place your fingers within 2.5 cm (1 in) of the Seal Safe system’s sealing jaw, or you may
receive a radio frequency (RF) burn.
Caution: Use the Seal Safe system only on tubing distributed by Terumo BCT. The Seal Safe system may not
perform as expected on other tubing.
Perform the following steps to seal the lines to the fluid containers and the bags using the Seal Safe system:
1 Hold the sealer head in the palm of your hand with your fingers on the plastic cover of the lever, so that the
jaws open facing upward and you can see the indicator light on the head (Figure 15-1).
Figure 15-1: Hold the sealer head with jaws open facing upward
2 Place the tubing into the jaw of the head and squeeze the lever until the jaw is completely closed and the
indicator light illuminates (Figure 15-2).
Figure 15-2: Hold the jaw closed until the indicator light illuminates
3 After the indicator light goes off, hold the jaw closed for one second, and then release the lever.
4 Remove the tubing and inspect the integrity of the seal.
5 Put the sealer head back into the holder on the Spectra Optia system.
15
Data Description
AC in collection bag Total volume (mL) of AC from the AC container that is in the collection bag
AC in plasma bag Total volume (mL) of AC from the AC container that is in the plasma bag
AC in remove bag Total volume (mL) of AC from the AC container that is in the remove bag
AC to patient Total volume (mL) of AC from the AC container that the patient received
AC used Total volume (mL) of AC that was used during the run
AC used for prime Total volume (mL) of AC from the AC container that was used for priming the tubing set
Bolus Total volume (mL) of fluid that was delivered to the patient for a bolus
Blood removed Total volume (mL) of blood that is in the remove bag
BM cycles Total number of times that the system processed the bone marrow volume (BMV)
BM processed Total volume (mL) of bone marrow that the inlet pump processed during the run
Collect Total volume (mL) of cells and AC that the collect pump processed into the collection bag
Collection bag Combined volume (mL) of cells, AC, and plasma that are in the collection bag
Custom prime Total volume (mL) of fluid that was used for the custom prime
End time Time the system completed the run or rinseback, if rinseback was performed
FCR Percentage (%) of starting defective cells remaining in the patient’s blood at the end of the run
Fluid balance Patient fluid balance (mL or %) at the end of the run. This does not include any bolus volume.
Inlet processed Total volume (mL) of fluid, including whole blood and AC, that the inlet pump processed
Plasma bag The total volume (mL) of plasma that is in the plasma bag. This includes AC.
Plasma in collection bag Total volume (mL) of plasma that the plasma pump processed into the collection bag. This
includes AC.
Plasma removed Total volume (mL) of plasma that is in the remove bag
Plasma treated Total volume (mL) of the patient’s plasma that was treated
Plasma volumes exchanged Total number of the patient’s plasma volumes that were exchanged
Plasma volumes treated Total number of the patient’s plasma volumes that were treated
Remove bag Total volume (mL) of saline, AC, and blood in the remove bag
Replaced:Depletion Total volume (mL) of replacement fluid used during the depletion
Replaced:Exchange Total volume (mL) of replacement fluid used during the exchange
Replacement used Total volume (mL) of fluid that the replace pump processed. This does not include any bolus
volume.
Data Description
Rinseback Total volume (mL) of fluid that the return pump processed during rinseback. This does not
include any bolus volume delivered during rinseback.
Run time Total time (min) that was taken to process inlet volume before the run targets were attained.
This does not include the time to complete rinseback or the time when the inlet pump was
paused.
Saline diverted Total volume (mL) of saline used to prime the tubing set that was diverted to the saline
container after the run started
Saline rinse Total volume (mL) of saline that was used for the saline rinse
Saline to patient due to air Total volume (mL) of saline delivered to the patient due to the system removing air from the
removal return line
Target Hct Target Hct (%) for the patient at the end of the run
TBV processed
Tubing set
Total number of patient TBV that were processed
Difference between the volume (mL) of fluid in the tubing set at the start of the run and the
volume in the set at the start of rinseback, or at the end of the run if rinseback is not
15
performed. A negative value indicates that there is fluid volume in the set.
Volume removed Total volume (mL) of fluid that the plasma pump processed
Volume replaced Total volume (mL) of fluid that the replace pump processed. This does not include any bolus
volume or the volume of a saline prime
Whole blood processed Total volume (mL) of the patient’s blood that the inlet pump processed during the run.
Once you finish the procedure and raise the cassette, perform the following steps to remove the tubing set:
1 Open the centrifuge door.
2 Remove the upper collar from the collar holder by grasping the lines above and below the collar and pulling
the lines downward.
3 Remove the upper and lower bearings from the bearing holders.
4 If you are using a Collection Set, remove the chamber from the bracket.
5 Gently pull the channel from the filler.
6 Push in the locking pin on the centrifuge collar holder, and remove the collar from the holder by grasping
the tubes above the collar and pulling upward.
7 Push the filler latch pin toward the center of the centrifuge, and raise the filler latch.
8 Fold the channel in half, and pull the channel through the loading port and out of the centrifuge chamber.
9 Lower the filler latch.
10 Close the centrifuge door.
11 Remove the lines from the fluid detectors.
12 Remove any bags from the IV pole.
13 Press the latch on the upper right corner of the cassette tray, and lift the cassette from the tray.
14 Discard the tubing set, according to your standard operating procedures.
Troubleshooting Alarms
The Spectra Optia system has independent control and safety systems that constantly monitor the performance of
the system. If either system detects an operation error or a potentially unsafe operating condition, the system
sounds an alarm and illuminates the warning lights on the monitor. The warning lights remain constant if the
control system detected the error, and flash if the safety system detected the error.
The operator plays an essential role in the safe operation of the system. If an alarm occurs, it is crucial for the
operator to consider all possible causes for the alarm and thoroughly read the instructions that appear on the screen
to resolve the alarm. It is the operator’s responsibility to determine if it is safe to continue the procedure, and to
follow the appropriate instructions.
1
2
5
3
Area Description
1 Alarm name States the name of the alarm that occurred.
2 Alarm explanation Provides a brief explanation of the condition that caused the alarm.
3 Possible causes Lists the possible causes of the alarm in order of most likely (top) to least likely
(bottom). Each possible cause is an active button that you can touch to display the
action steps you should perform to resolve the condition causing the alarm.
4 Scroll button Indicates that additional possible causes for the alarm condition exist. Touch the button
to view the additional causes.
5 Action buttons Displays buttons of available actions that you can touch to help resolve the condition.
For details, read the action steps for the possible cause before you touch an action
button.
1
2
3
4
Area Description
1 Alarm name States the name of the alarm that occurred.
2
3
Alarm explanation
Possible cause
Provides a brief explanation of the condition that caused the alarm.
Shows the possible cause of the alarm, which was selected from the list on an active
16
alarm screen.
4 Action steps Shows the action steps to perform to resolve the condition causing the alarm.
Note: Most alarm conditions can be resolved by reading the possible causes for the alarm and following the
instructions on the alarm actions screens. It is not necessary to contact a service representative unless instructed.
Note: You must resolve all conditions causing alarms before you can resume the procedure. The active alarm button
appears at the bottom of the screen if there are additional conditions to resolve. Some conditions may resolve
themselves when you troubleshoot other conditions, and as a result will disappear from the list of active alarms.
When the system is operating in Semi-Automatic mode, the AIM system does not control the position of the
interface. The system controls the interface position using the entered hematocrit and other procedure values.
There are two reasons to enter Semi-Automatic mode:
• You may choose to enter Semi-Automatic mode with the AIM system enabled if certain procedure conditions
occur.
• You may be required to disable the AIM system and enter Semi-Automatic mode to resume the procedure if
certain alarm conditions occur.
Exchange procedures
1 Look through the viewport to view the interface position. The interface position should appear low and the
RBC layer should be thin.
To adjust the interface position, go to the patient data screen and change the entered Hct. If the position
seems too high, increase the Hct by 3 percentage points. You may do this up to three times for a total increase
of 9 percentage points.
2 Monitor the interface position and adjust the position again, if necessary.
Proper anticoagulation of the system's extracorporeal circuit ensures that the flow of blood and fluid through the
circuit is not obstructed during the procedure. Terumo BCT recommends that you use an inlet:AC ratio up to 15:1
when using ACD-A. The system’s default inlet:AC ratio depends on the procedure selected. You may need to use a
different ratio, however, for a patient with a unique hematologic condition. If the circuit is not adequately
anticoagulated, platelet aggregates or clots may form, and eventually cause an obstruction in one or more of the
following areas:
• Filter at the bottom of the reservoir
• Collect port (Collection Set, IDL Set)
• Tubing set connector, which can result in an unstable interface
To eliminate the aggregates or clots, decrease the inlet:AC ratio. If an alarm occurs indicating a possible obstruction,
follow the instructions on the alarm action screen, and monitor the system for the rest of the procedure. If you do
not eliminate the obstruction, the system may require that you discontinue the procedure.
– If rinseback is an option, consider completing stage 1 of rinseback. Touch the Rinseback tab and
follow the instructions on the screen to perform rinseback. During stage 1, the centrifuge does not
spin. After the system starts pumping saline into the tubing set and spinning the centrifuge to
complete stages 2 through 4, the alarm could recur. If the alarm recurs, touch the Disconnect tab
and follow the instructions on the screen to disconnect the patient and end the procedure.
– If rinseback is not an option, touch the Disconnect tab, and follow the instructions on the screen to
disconnect the patient and end the procedure.
4 Follow the instructions in Chapter 17, “Maintaining the Spectra Optia System,” to disinfect the centrifuge
chamber. If you are unable to adequately perform the disinfection, contact your Terumo BCT representative
for assistance.
Note: If power to the device has been off for more than 8 hours, the system might not allow you to resume the
procedure.
Note: Ensure that you do not seal the line to the vent bag. If you seal the line, you will not be able to resume
the manual rinseback.
16
6 Turn off the Spectra Optia system.
Figure 16-3: RBC valve in the return position (Exchange Set shown here)
Note: Do not seal the RBC line instead of clamping it. If you seal the line, the tubing set could leak when you
raise the cassette to unload the set.
Figure 16-4: Where to clamp the RBC line (Exchange Set shown here)
4 Gently squeeze the vent bag to push the fluid from the reservoir to the patient. This should take several
minutes to complete. Do not try to expedite this process by applying more pressure to the bag.
Warning: Do not apply excess pressure to the vent bag when pushing fluid from the reservoir to the
patient during a manual rinseback or you could damage the red blood cells that you are returning to the
patient.
5 When the level of fluid in the reservoir drops to the level of the reservoir filter (Figure 16-6), clamp the
return line and stop squeezing the vent bag. .
Warning: Do not continue to squeeze the vent bag after the fluid in the reservoir reaches the level of the
reservoir filter during a manual rinseback. If you continue to squeeze the bag, you could deliver air to the
patient.
Figure 16-6: Level of fluid in the reservoir at the level of the reservoir filter (Exchange Set shown here)
9
housing.
If the system functions, perform the following steps: 16
a. Turn on the system.
b. Touch Disconnect to discontinue the procedure.
c. Touch Unload to raise the cassette.
d. Unload the tubing set.
10 If the system does not function, manually raise the cassette according to the instructions on page 226, and
then unload the tubing set.
Manual Method for Opening the Centrifuge Door and Raising the
Cassette
If the power to the system is interrupted when the centrifuge is spinning, or the system does not function correctly,
the pumps stop and the centrifuge door may not open. To unload the tubing set, you need to manually open the
centrifuge door and raise the cassette.
Note: Do not use a cotton swab, stick, or other breakable object to manually open the centrifuge door, as it
may break and jam the door.
4 Turn each valve to the neutral position using a flat-blade screwdriver (Figure 16-8).
6
b. Pull the rotor off the pump.
Insert the screwdriver into the small hole in the vent on the back of the system (Figure 16-9) until you
engage the slotted end of the pin attached to the back of the cassette tray. You may need to angle the
16
screwdriver to locate the pin.
Figure 16-9: Screwdriver inserted in the hole in the back of the system
7 Turn the screwdriver counterclockwise until it no longer turns, and the cassette tray is in the fully raised
position.
8 Follow the instructions on page 214 to remove the tubing set from the system.
Warning: When cleaning and disinfecting equipment surfaces that might have been exposed to blood, take
adequate precautions to prevent possible exposure to and transmission of infectious diseases.
The cleaning solutions listed below are compatible for use on the Spectra Optia system. Use the solution specified
in the instructions when cleaning.
• Mild detergent
• 70% isopropyl alcohol
• Water
The disinfecting solutions listed below are compatible for use on the Spectra Optia system.
• 0.63% sodium hypochlorite
• 70% isopropyl alcohol
• 0.50% ammonium chloride
If the disinfecting solution used by your facility contains an active ingredient that is not on this list, test the
solution before use by applying it to an inconspicuous area on the system to confirm that is does not damage or
discolor the system.
The materials listed below are recommended for use alone or in conjunction with a compatible cleaning or
disinfecting solution. Avoid using abrasive material, which could damage the function of the components and the
appearance of the system.
• Gauze pad
• Soft lint-free cloth
• Cotton swab
• Commercial or industrial wipe that is pre-moistened with a compatible solution from the lists above.
17
Touch screen
Caution: To avoid damaging the touch screen, do not douse the touch screen with fluid or leave fluid on the
screen after cleaning or disinfecting the screen. Always dry the screen with a gauze pad or a clean cloth after
exposing it to fluid.
Valves
Wipe the surfaces of the valves, using mild detergent or a disinfecting solution.
2 Wipe the housing and the rotor, using mild detergent or a disinfecting solution.
Note: If necessary, you can rinse the pump rotors with water or mild detergent before disinfection to loosen
any residue left by a spill.
3 Wipe the rotor again using water to remove any residue left by the detergent or solution.
4 Allow the rotor to air-dry before replacing it in the housing.
5 Align the rotor with the housing. Ensure that the metal bar in the housing aligns with the corresponding slot
in the rotor. Push in the rotor and turn it to the right to lock the rotor in place. If you do not properly install
the rotor, an alarm will occur the next time you load a tubing set. 17
Note: Ensure that you install the rotor with the black dot in the housing for the replace/collect pump.
Caution: Use only a gauze pad, a lint-free cloth, or a wipe when cleaning or disinfecting the touch screen, the
covers on the AIM system lights in the centrifuge, and the aperture plate on the filler. Use of an abrasive brush,
scrub material, or a sharp object can damage the surface of the components.
Filler
1 Follow the instructions on page 64 to remove the filler from the centrifuge.
2 Wipe the filler, using a mild detergent or a disinfecting solution. Use a cotton swab to clean the groove of
the filler and a dry cotton swab or alcohol pad to remove excess fluid.
Note: If necessary, you can rinse the filler with water or mild detergent before disinfection to loosen any
residue left by a spill.
3 Wipe the surfaces of the aperture plate, using water to remove any residue that was left by the cleaning
solution or disinfecting solution.
4 Dry the aperture plate, using a gauze pad or a soft, lint-free cloth.
5 Allow the remaining surfaces of the filler to air-dry completely.
6 Follow the instructions on page 65 to re-install the filler on the centrifuge.
3 Clean the jaw cavity, using a cotton swab dampened with alcohol. Do not use other cleaning or disinfecting
solutions to clean the cavity (Figure 17-2).
4 Clean all areas outside the jaw cavity. Squeeze the lever to expose areas outside of the cavity, and clean those
areas.
5 Dry all parts of the jaw and jaw cavity, using a cotton swab.
4 Remove the lever by slightly releasing the jaw and pulling the lever down and back (Figure 17-4).
3 Use your thumb to slightly depress the jaw. Ensure that the spring stays in place.
4 Replace the lever by tipping it at a 45° angle and positioning the lever pivots behind and below the pivot
slots (Figure 17-7).
17
5 Push down the lever to engage the lever pivots while simultaneously depressing the jaw with your thumb.
6 Release your thumb. The lever should fully engage and secure the jaw on the sealer head.
7 Squeeze the lever to ensure that the head mechanically functions. If the jaw does not completely close, check
the position of the spring.
8 Attach a new splash guard, if required, according to the instructions “Attaching a new splash guard” below.
9 Reconnect the RF cable to the sealer head and put the sealer head back into the holder.
c. Fold the sides of the splash guard inward at the perforations (Figure 17-9).
3 Align the splash guard with the lever assembly on the sealer head.
4 Attach the splash guard and use the clip to lock it in place (Figure 17-10).
5 Reconnect the RF cable to the sealer head and put the sealer head back into the holder.
Frequency
Component After Each Procedure Weekly Monthly
System surface • Use mild detergent.
• Allow to air-dry.
Centrifuge chamber:
filler aperture plate and optical
• Use water only.
• Allow to air-dry.
17
reference
Ethernet port Port is electrically isolated. • Location where a device can be connected
to the system to print reports or to collect
and transmit data to Terumo BCT
• Location where service personnel can
connect to the system to download
procedure information to a computer when a
patient is not connected
Environmental
Cleaning • Surface of the device can be cleaned and Device is not damaged by cleaning and
disinfected disinfecting with the compatible cleaning
• Pump rotors can be removed for cleaning solutions and disinfecting solutions, according
and disinfection to the instructions described in Chapter 17 of
• Channel leaks are contained within the this manual.
centrifuge chamber
• Centrifuge chamber can be cleaned and
disinfected
Cleaning Components can be cleaned and disinfected. Device is not damaged by cleaning and
disinfecting with the compatible cleaning
solutions and disinfecting solutions, according
to the instructions described in Chapter 17 of
this manual.
Physical
System weight plus Safe Working 102 kg (225 lb) Safe Working Load is the maximum external
Load load that includes tubing set, accessories, and
solutions.
System Components
Centrifuge
Table 18-9: Centrifuge speed and g-force
Pumps
Plasma pump • MNC collection procedures: Up to 125 mL/min Operator can enter a pump flow rate
• All other procedures: Up to 142 mL/min from within this range during the
procedure.
Collect pump • MNC collection procedures: 0.5 mL/min to Operator can enter a pump flow rate
10 mL/min from within this range during the
• During accumulation phase: Up to 3 mL/min procedure.
• During collection phase: Up to 7 mL/min
Fluid replaced accuracy WBCD, PLTD procedures: ± 10% or 100 mL up • Applies if replacement fluid is administered
to 2 TBV processed during the procedure
• Normal operating conditions
• No line restrictions
• Volume accuracy can be affected by the
temperature and viscosity of the fluids.
Volume accuracy of all pumps ± 6% or 20 mL of displayed value, whichever • Normal operating conditions
is greater • No line restrictions
• Pump accuracy can be affected by the
temperature and viscosity of the fluids.
Alarm occurrence When fluid is not detected at the low-level System performs a duplicate (redundant)
sensor, the system stops the pumps before air safety check. If condition is not resolved after
enters the line. a specific number of tries, operator must
disconnect patient.
System Software
Safety system
Table 18-20: Safety system
Alarms
Table 18-21: Basic safety and performance requirements
• AC is flowing directly to the patient. • AC pump flow rate is greater than the inlet
pump flow rate for more than 0.4 mL net AC
pumped to the patient.
• Inlet:AC ratio is too high. • System calculated inlet:AC ratio that is 20%
above the operator-specified value for 10 mL
of inlet volume.
18
Maximum ECV
Procedure Tubing Set Filler Typical ECV (mL)
(mL)
TPE:
• Dual-needle access • Exchange • Standard • 141 • 185
• Single-needle access • Exchange • Standard • 185 • 185
Collection bag volume 940 mL Bag is a component of the Collection Set and
the IDL Set.
Plasma bag volume • Liquid: 1,000 mL • Bag is a component of the Collection Set, the
• Frozen: 600 mL IDL Set, and the BMP Accessory Set.
• Volume shown is the maximum target
volume.
Sterile barrier filter Collection Set and IDL Set: Filter is on the AC line and on the saline line.
• 0.2 microns.
• Helps to maintain a functionally closed
system.
Administration line filter on BMP 200 microns. Can be used for additional Filter is used for additional filtration of bone
Accessory Set filtration of bone marrow. marrow, if desired.
RBC residual volume • When rinseback is performed (average Normal operating conditions
volume):
• Exchange Set: 10 mL
• Collection Set: 10 mL
• IDL Set: 17 mL
• When rinseback is not performed: Equal to
the ECV of the tubing set multiplied by the
patient’s Hct
18
Note: The EMISSIONS characteristics of this equipment make it suitable for use in industrial areas and hospitals
(CISPR 11 class A). If it is used in a residential environment (for which CISPR 11 class B is normally required) this
equipment might not offer adequate protection to radio-frequency communication services. The user might need to
take mitigation measures, such as relocating or re-orienting the equipment.
Conducted and radiated RF Group 2 The Spectra Optia system emits RF for the Seal Safe
emissions Class A system, so the Seal Safe can perform its intended function.
CISPR 11 The RF is only emitted when sealing tubing. Nearby
electronic equipment may be affected.
Table 18-28: Immunity tests and test levels 60601-1-2 (4th Ed.)
Radiated RF EM 3 V/m
fields 80 MHz to 2.7 GHz
IEC 61000-4-3 80% AM at 1 kHz
For proximity fields See immunity test levels and test frequencies in Table 18-29
from RF wireless
communications
equipment
IEC 61000-4-3
Table 18-28: Immunity tests and test levels 60601-1-2 (4th Ed.) (continued)
Conducted 3V
disturbances induced 0.15 MHz to 80 MHz
by RF fields 6 V in ISM bands between 0.15 MHz and 80 MHz
IEC 61000-4-6 80% AM at 1 kHz
0% UT; 1 cycle
70% UT; 25 cycles
Single phase: at 0°
UT 100 V and 230 V
Table 18-29: Test specification for ENCLOSURE PORT IMMUNITY to RF wireless comm. equip. 60601-1-2 (4th Ed.)
Test IMMUNITY
frequency
(MHz)
Band (MHz) Service Modulation
Maximum
power (W)
Distance
(m)
TEST LEVEL
(V/m) 18
385 380 to 390 TETRA 400 Pulse modulation 18 Hz 1.8 0.3 27
710
704 to 787 LTE Band 13, 17 Pulse modulation 0.2 0.3 9
745
217 Hz
780
Table 18-29: Test specification for ENCLOSURE PORT IMMUNITY to RF wireless comm. equip. 60601-1-2 (4th Ed.) (continued)
Test IMMUNITY
Maximum Distance
frequency Band (MHz) Service Modulation TEST LEVEL
power (W) (m)
(MHz) (V/m)
1.720 GSM 1800
1.700 to 1.990 CDMA 1900 Pulse modulation 2 0.3 28
1.845 GSM 1900 b) 217 Hz
1.970 DECT; LTE Band 1,
2, 3, 25; UMTS
5.240
5.100 to 5.800 WLAN 802.11 a/n Pulse modulation 0.2 0.3 9
5.500
b) 217 Hz
5.785
Note: The term “emissions” refers to the effects that the system can have on other devices in its vicinity.
RF emissions Group 2 Seal Safe system emits RF when sealing tubing. Nearby
CISPR 11 electronic equipment not compliant with standard
IEC 60601-1-2 or standard CISPR 24 may be affected.
RF emissions Class A System is suitable for use in all establishments other than
CISPR 11 residential and establishments directly connected to the
public low-voltage power supply network that supplies
power to buildings used for residential purposes.
Electromagnetic immunity
Note: The term “immunity” refers to the system’s ability to operate correctly in the presence of electromagnetic
disturbances. 18
Table 18-31: Electromagnetic immunity 60601-1-2 (3rd Ed.)
Immunity Test Test Level IEC 60601 Compliance Level Electromagnetic Environment
Electrostatic ± 6 kV contact ± 6 kV contact
discharge ± 8 kV air ± 8 kV air
IEC 61000-4-2
Electrical fast ± 2 kV for power supply ± 2 kV for power supply Quality of the main power supply should be
transient/burst lines lines that of a typical blood center or a hospital
IEC 61000-4-4 ± 1 kV for input and output ± 1 kV for input and output environment.
lines lines
Surge IEC 61000-4-5 ± 1 kV line to line ± 1 kV line to line Quality of the main power supply should be
± 2 kV line to earth ± 2 kV line to earth that of a typical blood center or a hospital
environment.
Immunity Test Test Level IEC 60601 Compliance Level Electromagnetic Environment
Voltage dips, short Class A Refer to Table 18-32.
interruptions, and
voltage variations on
power supply input
lines IEC 61000-4-11
Test Level
Immunity Test Compliance Levels Electromagnetic Environment
IEC 60601-1-2
100 V 230 V
Voltage dips, short < 5% UT < 5% UT < 5% UT • Quality of the main power supply
interruptions, and (> 95% dip in UT) for (> 95% dip in UT) for (> 95% dip in UT) for should be that of a typical blood
voltage variations on 0.5 cycles 0.5 cycles 0.5 cycles center or a hospital environment.
power supply input • Interruptions of the main power
lines < 40% UT < 70% UT < 40% UT supply at voltages of 100 or less
IEC 61000-4-11 (> 60% dip in UT) for (> 30% dip in UT) for (> 60% dip in UT) for will cause the system to restart
5 cycles 2 cycles 5 cycles and the procedure to resume as
permitted by IEC 61000-4-11.
< 70% UT < 85% UT < 70% UT • If power interruptions are
frequent, the use of a suitably
(> 30% dip in UT) for (> 15% dip in UT) for (> 30% dip in UT) for
rated uninterruptible power supply
25 cycles 25 cycles 25 cycles
is recommended.
< 5% UT < 5% UT < 5% UT
(> 95% dip in UT) for (> 95% dip in UT) for (> 95% dip in UT) for
5 seconds 5 seconds 5 seconds
Note: UT is the voltage of the main alternating-current power supply before use of the test level.
18
Note: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects, and people.
Note: At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
d = 2.3 P
800 MHz to 2.5 GHz
Note: At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
a Field strengths from fixed transmitters—such as base stations for radio telephones (cellular and cordless) and land mobile radios, amateur
radios, AM and FM radio broadcasts, and TV broadcasts—cannot be theoretically predicted with accuracy. To assess the impact of fixed RF
transmitters on the electromagnetic environment, consider performing an electromagnetic site survey. If the measured field strength in the
location in which the system is used exceeds the applicable RF compliance level, the system should be observed to confirm normal operation. If
abnormal performance is observed, it may be necessary to reorient or relocate the system.
The Spectra Optia system is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. According to immunity test data, it is unlikely that commonly used communication
devices such as cell phones or other wireless-equipped devices meeting 802.11g/n standards will adversely affect the
Spectra Optia system. However, if electromagnetic interference is noticed, or higher-powered devices such as
two-way radios are to be used in the vicinity of the Spectra Optia system, the user can help prevent interference by
maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and
the Spectra Optia system. Refer to Table 18-35 for recommended separation distances according to the frequency
and maximum output power specified by the manufacturer of the communications device.
Table 18-35: Recommended separation distances between portable and mobile RF communications devices and the Spectra Optia
system 60601-1-2 (3rd Ed.)
100 12 12 23
Note: For transmitters rated at a maximum output power not listed in the table, the recommended separation distance d in meters can be
estimated using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the transmitter in
watts, according to the transmitter manufacturer.
Note: At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
Symbol Definition
Indicates that the product was manufactured in accordance with Annex II of the European Council
Directive 93/42/EEC, as amended.
Indicates that the device is certified by CSA International in accordance with applicable U.S. and
Canadian standards for conformance with the requirements of CAN/CSA-C22.2 No. 601-1-M90,
CAN/CSA-C22.2 No. 1010.2.20-94, and UL 60601-1, as well as the applicable respective
amendments to these standards.
Indicates that the device is classified as Type BF per safety standard EN 60601-1. This classification
is based on the degree of protection against electrical shock, as defined in that standard.
Indicates that the device is protected against access by solid objects and falling water, as defined in
IP21
standard IEC 60529.
Indicates a protective conductor terminal. The symbol is located near the chassis’ grounding
locations.
Indicates a protective earth ground. The symbol is located near the chassis’ main grounding location
and at other protective ground points.
18
Indicates that the main power is turned on.
Indicates that the equipment is subject to directive 2012/19/EU concerning waste electrical and
electronic equipment (WEEE) and must be disposed of accordingly.
Symbol Definition
Indicates a medical device that is intended for one use or for use on a single patient during a single
procedure.
Indicates the date when the medical device was manufactured (or sterilization date, if the product is
sterile).
Indicates the product quantity when the quantity is placed in the square.
Indicates the manufacturer’s batch code so that the batch or lot can be identified.
Indicates the date after which the medical device is not to be used.
Indicates the presence of a sterile fluid path. The method of sterilization is ethylene oxide (EO).
Indicates the manufacturer’s catalog number so that the medical device can be identified.
Indicates that the user should consult the instructions for use.
Symbol Definition
Indicates a medical device that needs to be protected from moisture.
Indicates that the product packaging complies with European Directive 94/62/EC for packaging and
packaging waste.
Indicates that the product contains phthalates, specifically Di(2-ethylhexyl) phthalate (DEHP).
Indicates the range of temperatures to which the device can be safely exposed.
Indicates the range of humidity to which the device can be safely exposed.
Indicates that stacking of the transport package is not allowed and no load should be placed on the
transport package.
Metric
Female 183 + [356 × height3 (meters)] + [33.1 × weight (kg)]
English
Female 183 + [0.005835 × height3 (inches)] + [15 × weight (lb)]
1 Load the blood warmer tubing set onto the blood warmer. Be sure to leave enough tubing on each end of the
set to allow connection to the replace line.
2 Clamp one end of the blood warmer tubing set.
3 Clamp both replace lines.
4 Unscrew the luer connector on the replace line.
5 Connect the female end of the luer connector on the blood warmer tubing set to the male end of the luer
connector on the replace line.
6 Spike the replacement fluid container with the replace line and squeeze the drip chamber.
7 Unclamp both replace lines to prime the lines and fill the drip chamber on the second replace line.
8 Reclamp the second replace line.
9 Unclamp the blood warmer tubing set and prime the tubing set.
10 Reclamp the blood warmer tubing set.
11 Connect the male end of the luer connector on the blood warmer tubing set to the female end of the luer
connector on the replace line.
12 Put the replace line into the replacement fluid detector so that the luer connector is below the fluid detector
and the manifold is above the fluid detector. The luer connector must be positioned below the replacement
fluid detector.
Note: Ensure that you put the luer connector below the replacement fluid detector. If the blood warmer tubing set is
not positioned below the fluid detector and the tubing fills with air during the procedure, you must disconnect the blood
warmer tubing set at the luer connector and manually reprime the set. If you do not reprime the set, the vent bag could
overfill with air.
Note: Testing on the needleless injection port included swabbing the surface of the port with 70% isopropyl
alcohol for 25 to 30 seconds and allowing it to air-dry for 1 minute.
2 Using aseptic technique, carefully connect the syringe or the extension tubing set to the port by pushing the
syringe or other luer connector straight into the port using a clockwise, twisting motion. Do not try to
connect to the port at an angle or to pry open the slit in the port. Once the connection is made, ensure that
it is secure.
3 To disconnect from the port, twist the syringe or connector counterclockwise. The port completely closes
after each use and therefore does not require a separate injection port cap.
4 Flush the port after each use according to your SOP.
Using the Needle Protector on the Inlet Needle of the Collection Set and the IDL Set
The inlet needle on the Collection Set and the IDL Set has a needle protector to protect you from accidental injury
when you remove the needle. Follow the instructions below to correctly insert and remove the inlet needle.
Note: To prevent fluid from flowing from the collection bag towards the luer connector, do not remove the syringe
from the luer connector before you clamp the line above the frangible connector.
8 To ensure that you delivered all of the anticoagulant in the syringe into the collection bag, perform the
following steps:
a. Attach a syringe containing at least 2.3 mL of saline to the luer connector. (The volume of the accessory
line and sterile barrier filter is approximately 2.3 mL.)
b. Unclamp the line above the frangible connector.
c. Slowly inject the saline through the sterile barrier filter to flush the anticoagulant from the filter into the
collection bag.
d. Clamp the line above the frangible connector.
e. Remove the syringe from the luer connector.
4 Remove the needle or the needleless adapter from the sampling port.
5 Transfer the sample to a test tube or other container.
6 Discard the sample bulb.
To determine the weight of the collected product, you must subtract the weight of the tare bag from the weight of
the collection bag after the procedure is completed.
Note: If you are connecting the system to the printer via a network device, such as a router or a switch, use a
standard Ethernet cable.
Perform the following steps to connect your Spectra Optia system to a printer:
1 Connect one end of the crossover cable to the printer and the other end of the cable to the Ethernet port on
the Spectra Optia system. The Ethernet port is located on the bottom right side of the back of the system next
to the connection for the power cord.
2 Configure the parameters and options on the report configuration screen to use a printer to print a copy of
the report. See Table 4-3 on page 51 for descriptions of the parameters and options.
3 Touch Test on the connection button to verify the connection between the system and the printer.
For additional information about connecting a printer to the Spectra Optia system, contact your Terumo BCT
service representative.
Note: If you are connecting the system to the printer via a network device, such as a router or a switch, use a
standard Ethernet cable.
Perform the following steps to connect your Spectra Optia system to a computer:
1 Connect one end of the cross-over cable to the computer, and the other end of the cable to the Ethernet port
on the Spectra Optia system. The Ethernet port is located on the bottom right side of the back of the system
next to the connection for the power cord.
2 Configure the parameters and options on the report configuration screen to use a computer to print a copy
of the report. See Table 4-3 on page 51 for descriptions of the parameters and options.
3 Touch Test on the connection button to verify the connection between the system and the computer.
For additional information about connecting a computer to the Spectra Optia system, contact your local
Terumo BCT service representative.
Printing a Report
Perform the following steps to deliver the report to either a printer or a computer for printing:
1 Touch the Data menu button. The data tabs appear.
2 Touch the Report tab. The screen appears with a list of reports in order of the most recent procedure to the
least recent procedure. The reports are identified by the procedure date, start time, procedure type, and
patient’s TBV. To view additional reports, touch the scroll bar.
Note: The button on the screen for the report for a procedure that was just completed is labeled Current.
3 Touch the button that corresponds to the report that you want to print. The report appears on the screen.
A
4 Touch the button at the top left side of the report to deliver a copy of the report to the device specified on
the report configuration screen as follows:
• If you selected a printer, Print appears on the button.
• If you selected a computer, Print to File appears on the button.
• If you did not select a device and intend only to view the report, No Device appears on the button.
Glossary of Terms
A Abbreviation for ampere.
AC Abbreviation for anticoagulant.
AC infusion rate Rate in mL/min/L TBV at which anticoagulant is infused to the patient
during the run.
ACD-A Anticoagulant used during apheresis procedures. ACD-A stands for
Anticoagulant Citrate Dextrose Solution A.
Administration line Component of the BMP Accessory Set used to transfer bone marrow
from the transfer bag (BM bag) into the accessory set.
AIM Abbreviation for automated interface management.
AIM system Optical detection system used by the Spectra Optia system to monitor
and control the position of the interface in the channel.
Albumin Plasma protein that helps to maintain fluid balance and to control the
viscosity of plasma.
Allogeneic Describes a blood transfusion or transplantation in which the donor and
the recipient are different but of the same species.
Alloimmunization Transfusion complication whereby a recipient develops antibodies toward
antigens from a donated blood product.
A/m Abbreviation for ampere per meter.
Anticoagulant Agent used to prevent the formation of blood clots.
Antigen Foreign substance capable of stimulating an immune response when
introduced into the body.
Apheresis Blood component separation procedure in which whole blood is drawn
from a patient or donor, and passed through a device that separates the
blood into components. Particular components are either removed or
collected, and the remaining components are returned.
Autologous Describes a blood transfusion or transplantation in which the donor and
the recipient are the same.
Bearing Hard plastic component of the centrifuge loop of the tubing set that
connects the loop to the centrifuge arm and to the entrance of the
centrifuge loading port.
Blood component In apheresis, the RBC, WBC, platelets, and plasma.
Blood warmer Device used to increase the temperature of fluid or blood delivered or
returned to a patient.
BM Abbreviation for bone marrow.
BM bag Bag containing source bone marrow before the bone marrow is
transferred into the BMP bag to perform a BMP procedure.
BMP bag Component of the BMP Accessory Set that holds the bone marrow
during a BMP procedure.
BMP procedure Apheresis procedure used to collect MNC from source bone marrow.
Bolus Dose of fluid given to a patient intended to mitigate hypovolemia.
Bone marrow Spongy tissue inside some bones that contains stem cells.
Buffy coat Fraction of blood after centrifugation that contains most of the white
blood cells and platelets.
Cassette Component of the tubing set that snaps onto the front panel of the
system and directs the flow of fluid through the set.
Catheter Tube that can be inserted into a vessel to allow the flow of blood or
injection of fluid.
Centrifugation Process that uses centrifugal force to separate a mixture.
Centrifuge loop Component of the tubing set. The group of lines that are loaded into the
centrifuge.
Channel Component of the tubing set used to separate a patient’s blood into
cellular components.
Chamber (Collection Set) Component of the Collection Set used for the secondary separation of
platelets and target cells.
Circulatory overload Elevation in blood pressure caused by an increase in blood volume.
CISPR Abbreviation for International Special Committee on Radio Interference,
a subcommittee of the IEC.
Citrate Salt or ester of citric acid that is used as an anticoagulant because it binds
calcium ion.
Citrate toxicity Condition that could occur in certain patients as a result of infusion of
ACD-A during an apheresis procedure. Mild forms of this condition are
generally recognized by peripheral paresthesia, tingling sensations in the
extremities, and/or restlessness. Severe forms of this condition can result
in significant cardiac dysfunction.
Clotting Result of activated platelets releasing chemicals that stimulate clotting
factors, causing the blood to coagulate.
Clumping Result of activated platelets sticking together during an apheresis
procedure.
B
CMNC Abbreviation for continuous mononuclear cell collection.
CMNC procedure Apheresis procedure used to collect MNC from a patient.
Collar Six-sided plastic component of the centrifuge loop of the tubing set that
secures the end of the loop in the centrifuge.
Collect line Component of the Collection Set and the IDL Set used to carry collected
blood components to the collection bag.
Collection bag Component of the Collection Set and the IDL Set used to hold collected
blood components for collection or depletion purposes.
Connector Component of the tubing set that secures the lines where the separated
components exit the channel. It may also facilitate separation.
Custom prime Process of filling the tubing set with specified fluid after priming the set
with saline and before starting the run. Useful when treating a patient
with a low RBC volume or low TBV to maintain isovolemia.
dB Abbreviation for decibel.
Default Setting or value that is preset by the manufacturer and used by the system
in the absence of a selection made by the operator.
Diversion bag Component of the Collection Set and the IDL Set used to capture a skin
plug after performing a peripheral venipuncture or to collect a blood
sample.
ECV Abbreviation for extracorporeal volume.
ERCV Abbreviation for extracorporeal red blood cell volume.
Electrolyte Mineral in blood and body fluids essential to the function of muscle
action and other body processes.
Electromagnetic compatibility Branch of electrical sciences that studies the unintentional generation,
propagation, and reception of electromagnetic energy with reference to
electromagnetic interference (EMI) that such energy may induce.
Electromagnetic compatibility ensures that, when used as intended,
electronic and electrical equipment works correctly when subjected to
certain amounts of EMI and does not emit EMI that could interfere with
other equipment.
EMC Abbreviation for electromagnetic compatibility.
Erythrocyte Term for a red blood cell.
Erythrocytapheresis Apheresis procedure used to separate RBC from a patient’s blood.
Ethylene oxide Chemical compound that is used to sterilize medical products and
devices.
EO Abbreviation for ethylene oxide.
Extracorporeal circuit Tubing that carries the blood when the blood is outside of the patient’s
body. This includes the Spectra Optia system tubing set and the tubing
set of any other device connected to the set.
Extracorporeal volume Volume of the patient’s blood that is outside of the body during an
apheresis procedure.
Extracorporeal red blood cell Number of the patient’s red blood cells that are outside of the body
volume during an apheresis procedure.
FCR Abbreviation for fraction of cells remaining.
Four-lumen tubing Lines that comprise the centrifuge loop of the tubing set.
Hz
facilitating collection of WBC.
Abbreviation for hertz. B
Inlet:AC ratio Ratio of the inlet pump flow rate to the AC pump flow rate, expressed as
parts of inlet volume to one part of anticoagulant.
Inlet access Refers to the patient access from which whole blood is drawn.
Inlet flow rate Speed at which blood is drawn from the patient.
Inlet line Line on the tubing set used to carry anticoagulated blood from the
patient to the channel.
Inlet pressure Force per unit of area on the blood flow as it is drawn from the patient.
Interface Area where the cellular components of blood meet the plasma in the
connector.
IEC Abbreviation for International Electrotechnical Commission, an
international standards organization for electrical, electronic, and related
technologies.
IP (Internet Protocol) address Numerical identifier for a computer or a device on a network that enables
communication among the devices on the network.
IV Abbreviation for intravenous.
kV Abbreviation for kilovolt.
Leukapheresis Apheresis procedure used to separate WBC from a patient’s blood.
Leukemia Cancer of the blood-forming cells in the bone marrow.
Lymphocyte Type of WBC.
Malaria Disease caused by a parasite and usually transmitted through a mosquito
bite, which infects the RBC.
Manifold Component of the tubing set. A connector with multiple ports used to
join a line with one or more other lines. It may also include an injection
port.
Manual rinseback Process whereby the operator, not the system, performs rinseback, in case
of a power or system failure.
MHz Abbreviation for megahertz.
mmHg Abbreviation for millimeters of mercury.
MNC Abbreviation for mononuclear cell or mononuclear cells.
MNC collection procedure Apheresis procedure used to collect MNC from a patient.
Mononuclear cell Type of WBC.
Obstruction Object or a condition that restricts the flow of fluid through the tubing
set.
Packed RBC Preparation of RBC with most of the plasma removed.
Packing factor Relationship between the inlet flow rate and the centrifuge speed that
indicates the degree of separation of the blood components during an
apheresis procedure.
Paresthesia Tingling sensation around the mouth that is a symptom of citrate toxicity
or hypocalcemia.
Patient access Refers to the device used to gain entry to a patient’s venous system.
Peripheral blood Blood in a vein or artery.
Peripheral blood stem cell Stem cell that circulates in the peripheral blood.
Plasma Fluid portion of the blood that transports proteins and enzymes through
the body.
Plasma bag Bag on the tubing set that holds collected plasma. This bag is on the
Collection Set and in the BMP Accessory Set.
Plasma device Short form for secondary plasma device.
Plasma line Line on the tubing set used to carry concurrently collected plasma to the
plasma bag. This line is on the Collection Set and on the IDL Set.
Plasmapheresis Apheresis procedure used to separate plasma from a patient’s blood.
Platelet Small cell fragment that aids in blood coagulation by helping to repair
damage to walls of blood vessels.
PLTD procedure Apheresis procedure used to collect excess platelets from a patient.
PLTD Abbreviation for platelet depletion.
PMN Abbreviation for granulocyte or granulocytes.
PMN collection procedure Apheresis procedure used to collect granulocytes from a donor.
Port number Numerical identifier used for the transmission of data between devices in
a network.
Primary run target Specific value that has been configured or entered on the run values
screen and that when attained, causes the system to end the run. A black
frame appears around the button of the primary run target to distinguish
it from other run targets.
Prime Process of pumping saline through the tubing set to prepare the set for the
run.
Procedure Series of steps performed to accomplish apheresis on the Spectra Optia
system. A procedure starts when the procedure is selected and ends when
the patient is disconnected.
Radio frequency Frequency in which radio waves are transmitted.
RBC Abbreviation for red blood cell or red blood cells.
RBCX Abbreviation for red blood cell exchange.
RCV Abbreviation for red blood cell volume.
Red blood cell Formed element of the blood responsible for delivering oxygen from the
lungs to the tissues and helping to return carbon dioxide from the tissues
to the lungs.
Red blood cell depletion procedure Type of red blood cell exchange procedure in which excess or defective
B
RBC are removed from a patient and replaced with desired replacement
fluid.
Red blood cell depletion/exchange Type of red blood cell exchange procedure that consists of a depletion
procedure procedure followed by an exchange procedure.
Red blood cell exchange procedure Apheresis procedure used to remove defective RBC from a patient and
replace them with healthy donor RBC.
Red blood cell volume Number of red blood cells in a specific unit or circulating in the patient’s
blood.
Remove bag Bag on the tubing set that holds the removed blood components. This
bag is only on the Exchange Set.
Remove line Line on the Exchange Set used to carry removed blood components from
the channel to the remove bag.
Replace line Line on the tubing set used to carry replacement fluid from the
replacement fluid container to the reservoir. This line is on the Exchange
Set and on the IDL Set.
Replacement fluid Fluid given to the patient during an exchange procedure to replace the
blood components removed.
Reservoir Component of the tubing set cassette that contains the fluid to be
returned to the patient.
Reservoir filter 200-micron filter located at the exit of the reservoir used to filter the fluid
returned to the patient.
Return access Refers to the patient access through which blood components and fluids
are returned.
Return flow rate Speed at which blood is returned to the patient.
Return line Line that carries fluid from the reservoir to the patient.
Return pressure Force per unit of area on the blood flow as it is returned to the patient.
RF Abbreviation for radio frequency.
Rinseback Process that clears the channel of remaining cells and returns them to the
patient after the run.
rpm Abbreviation for revolutions per minute.
Run State during a procedure when apheresis is performed. The run starts
when the patient is connected and ends when a run target is attained.
Run target One or more values that appear on the run values screen and on the run
targets screen that should be attained when the run ends. The system
predicts these values based on the primary run target.
Saline Sterile 0.9% sodium chloride and water solution used to prime the tubing
set and to perform an apheresis procedure.
Saline rinse Process that rinses the tubing set with saline before the run to clear the set
of any residual ethylene oxide, a by-product of sterilization.
Secondary plasma device Device used to treat the separated plasma before it is returned to the
patient.
Sickle cell disease Inherited blood disorder that affects the hemoglobin in RBC.
Single-needle access Single patient access for both the inlet access and the return access.
Spillover Condition when some RBC from the channel have entered the plasma
line.
SPD Abbreviation for the procedure on the Spectra Optia system that is
performed with a secondary plasma device.
sample bulbs, using 271 start time procedure summary data 213
screen buttons see buttons 35 starting defective RBC
screen color scheme 35 data entry range 119
screen description, alarm 216 description of 123
screen description, procedure 34 stop button 36
scroll buttons storage humidity, device 243
left and right 37 storage temperature, device 243
up and down 36 strobe lights 26
Seal Safe system 21 supplies required
cautions for use 14 all procedures 62
cleaning BMP procedure 194
jaw cavity 234 CMNC procedure 148
sealer head 235 custom prime 76
lines, sealing 210 MNC collection procedure 132
sealer head PLTD procedure 178
disassembling 235 PMN collection procedure 162
reassembling 237 RBCX procedure 117
splash guard, replacing 238 saline prime 79
warnings for use 8 TPE procedure 84
secondary plasma device see plasma device TPE-SPD procedure 98
selecting the procedure 64 WBCD procedure 178
Semi-Automatic mode icon 37 switch, power 21
Semi-Automatic mode, using 29 symbols, definitions of 261
AIM system disabled 219 symptoms of patient reactions to procedures 17
AIM system enabled 219 system cautions for use 9
CMNC procedure 220 System collection phase control 142
depletion procedures 220 system configuration 49
MNC collection procedure 220 system warnings for use 3
PMN collection procedure 220
sensors T
bar code reader 24
tabs, menu
pressure
BMP procedure 197
centrifuge 24
CMNC procedure 149
collect 24
MNC collection procedure 133
inlet 24
PLTD procedure 180
plasma 24
PMN collection procedure 164
return 24
RBCX procedure 117
reservoir
TPE procedure 85
high-level 24
TPE-SPD procedure 99
low-level 24
WBCD procedure 180
serial number, system 22
tare weight of collection bag, establishing 273
service cautions for use 10
target defective RBC
service information 15
data entry range 119
service warnings for use 4
description of 123
shipping humidity, device 243
Target Hct procedure summary data 213
shipping temperature, device 243
TBV of patient
single needle, TPE procedure
calculating, formula for 266
converting to 91
data entry range 86, 100, 118, 134, 150, 165, 181
decreasing run time 96
overriding system calculation 89, 121, 138, 153, 168,
description of 74, 84
184
selecting 80
TBV processed procedure summary data 213
single-needle icon 37
TBV processed, configuring 54, 55, 56, 57, 58
software verification configuration 49
temperature, device shipping and storage 243
SPD see TPE-SPD 52
test tube icon 38
Spectra Optia® Apheresis System Collection Preference Tool
time configuration
Collection Preference Tool 62
current time 49
splash guard, replacing 238
U
upper bearing holder 26
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