Terminology; System Operation And Anticoagulant Management - Gambro Cobe Spectra Essentials Manual

Anticoagulation

Terminology

AC infusion rate
The AC infusion rate is the rate anticoagulant is infused to the
donor/patient. It is expressed in mL of AC/minute/liter of the
donor/patient TBV. The Spectra system uses the donor/patient data
entered during a procedure to determine the donor/patient total blood
volume (TBV).
The default AC infusion rate is 0.8 mL/min/L of TBV. You can
configure the AC infusion rate for any procedure except TPE and
RBCX.
AC pump flow rate
The AC pump flow rate determines how fast AC is added to the blood
entering the Spectra system. The Spectra system automatically sets the
AC pump flow rate based on donor/patient TBV, the configured
AC infusion rate, and the volume of AC in the plasma
collected/removed.
Inlet:AC ratio
The inlet:AC ratio is the ratio of the inlet pump flow rate to the AC
pump flow rate and is expressed as parts of inlet blood to one part
anticoagulant. This ratio determines how well the extracorporeal circuit
is anticoagulated.
8-2
System Operation and Anticoagulant
Management
Managing the AC Infusion Rate
The AC infusion rate is based on the assumption that a donor or
patient's ability to metabolize citrate is directly related to their size or
TBV. Therefore, the Spectra system maintains a constant infusion rate of
anticoagulant per minute per liter of the donor/patient TBV.
Figure 8-1 illustrates the relationship among the AC infusion rate, the
patient's TBV, the AC infused to the patient and the AC removed with
the plasma, the inlet:AC ratio, and the AC and inlet pump flow rates.
The Spectra system calculates the donor/patient TBV based on sex,
height, and weight, and then controls how fast the donor/patient
receives anticoagulant based on the TBV and the configured
AC infusion rate. The default AC infusion rate is
0.8 mL/min/L of TBV. At the physician's discretion the AC infusion rate
can be configured to between 0.8 and 1.1 mL/min/L of TBV. For
additional information, see "Configuring the AC Infusion Rate" on
page 5-4.
Example:
TBV x Configured AC Infusion Rate = AC Returned to the Donor/Patient
5 liters x 0.8 mL/min/L of TBV = 4.0 mL/min
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COBE Spectra™ Apheresis System • Essentials Guide