Page 1 I n t r a - A o r t i c B a l l o o n P u m p ( I A B P ) S y s t e m O p e r a t i n g M a n u a l Arrow International 9 Plymouth Street Everett, Massachusetts 02149 (617) 389-6400 •...
Page 2 Copyright Copyright © 2006 Arrow International, Everett, MA 02149 USA Document Specification When making reference to or requesting additional copies of this document, please note the following Part Number: IAM-9007, Rev 0.
Page 3: Table Of Contents
T a b l e o f C o n t e n t s C H A P T E R 1 : C l i n i c a l U s e s 1 - 1 1 . 1 : C l i n i c a l U s e s o f I A B P ........1 - 3 Physiological Basis of IABP .
Page 4 T a b l e o f C o n t e n t s 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s ......3 - 1 8 Function Control Keys .
Page 5 T a b l e o f C o n t e n t s C H A P T E R 4 : P r i n c i p l e s a n d A p p l i c a t i o n o f C o u n t e r p u l s a t i o n T i m i n g , T r i g g e r i n g , A s s i s t R a t i o a n d B a l l o o n V o l u m e 4 .
Page 6 T a b l e o f C o n t e n t s 5 . 2 : C l i n i c a l E n v i r o n m e n t s ....... . . 5 - 1 8 The AutoCAT ®...
Page 7 T a b l e o f C o n t e n t s C H A P T E R 7 : C a l i b r a t i o n P r o c e d u r e s 7 - 1 7 .
Page 8 T a b l e o f C o n t e n t s C H A P T E R 1 0 : M a i n t e n a n c e a n d S e r v i c e 1 0 - 1 R o u t i n e M a i n t e n a n c e P r o c e d u r e s .
Page 9 I l l u s t r a t i o n s & T a b l e s I L L U S T R A T I O N S 3.1: The AutoCAT ® 2 Series IABP System Configuration ....3-5 3.2: The AutoCAT ®...
Page 10 I l l u s t r a t i o n s & T a b l e s I L L U S T R A T I O N S – c o n t i n u e d 10.1: The Condensate Collection Bottle .
Page 11 1 . C l i n i c a l U s e s C H A P T E R 1 : C l i n i c a l U s e s Intra-Aortic Balloon Pumping (IABP), or counterpulsation, is a widely accepted therapeutic method of temporarily supporting patients with impaired left ventricular function.
Page 13: C L I N I C A L U S E S O F I A B P
1 . C l i n i c a l U s e s 1 . 1 : C l i n i c a l U s e s o f I A B P Physiological Basis of IABP The overall goal of IABP is to provide cardiac support to patients whose myocardial oxygen supply and demand are imbalanced.
Page 14: Medical Indications
1 . C l i n i c a l U s e s 1 . 1 : C l i n i c a l U s e s o f I A B P Medical Indications Cardiogenic Shock 2,6,9,10,13,14,17,27,28,29 Cardiogenic shock is a physiological derangement of circulatory failure due to severe depression of myocardial function.
Page 15 1 . C l i n i c a l U s e s 1 . 1 : C l i n i c a l U s e s o f I A B P Threatening Extension of MI 16,17,18,23 If signs of myocardial ischemia continue after an infarction, a portion of the myocardium is in jeopardy.
Page 16 1 . C l i n i c a l U s e s 1 . 1 : C l i n i c a l U s e s o f I A B P Cardiac Contusion Contusion with subsequent infarction of the myocardium can occur with trauma to the chest wall.
Page 17: Mechanical Defects
1 . C l i n i c a l U s e s 1 . 1 : C l i n i c a l U s e s o f I A B P Mechanical Defects Mechanical defects that impede forward CO are another group of medical indications for IABP.
Page 18 1 . C l i n i c a l U s e s 1 . 1 : C l i n i c a l U s e s o f I A B P Valvular Insufficiency (Mitral) including Papillary Muscle Rupture The two types of valvular insufficiency are aortic insufficiency (see Section 1.2) and mitral insufficiency.
Page 19: Surgical Indications
1 . C l i n i c a l U s e s 1 . 1 : C l i n i c a l U s e s o f I A B P Surgical Indications Prophylactic support in Preparation for Cardiac Surgery or High risk cardiac patients undergoing Non-cardiac surgical procedures 5,8,19,20,28 Induction of anesthesia can be stressful to the cardiovascular system.
Page 20 1 . C l i n i c a l U s e s 1 . 1 : C l i n i c a l U s e s o f I A B P Maintenance of Graft Patency Post Coronary Artery Bypass Surgery IABP may not be needed to maintain graft patency after coronary bypass surgery.
Page 21: C O N T R A I N D I C A T I O N S A N D P O T E N T I A L C O M P L I C A T I O N S O F I A B
1 . C l i n i c a l U s e s 1 . 2 : C o n t r a i n d i c a t i o n s a n d P o t e n t i a l C o m p l i c a t i o n s o f I A B P Contraindications Intra-Aortic Balloon Pumping (IABP) requires an adequate location in which to place the balloon and a functional aortic valve.
Page 22: Potential Complications
1 . C l i n i c a l U s e s 1 . 2 : C o n t r a i n d i c a t i o n s a n d P o t e n t i a l C o m p l i c a t i o n s o f I A B P Potential Complications As with any invasive procedure, there are risks associated with IABP use.
Page 23: Chapter 2 : I N S T A L L A T I O N P R O C E D U R E S
C H A P T E R 2 : I n s t a l l a t i o n P r o c e d u r e s After the AutoCAT ® 2 Series IABP System is delivered to your hospital or purchasing facility, an Arrow International Field Engineer or representative will prepare the AutoCAT 2 Series for operation and thoroughly check its operational readiness. You ®...
Page 25: Pre-Installation Requirements
2 Series should be operated by educated personnel only. Make sure that you have allocated adequate education time for potential users. Arrow International, Inc. clinical specialists are willing to provide your staff with Basic or Advanced Education, according to your institution’s requirements. Arrow provides a 24-hour Support Line for questions regarding AutoCAT ®...
Page 26: Service Installation
To insure that your AutoCAT 2 Series IABP System is properly installed and ® operational, an Arrow International representative will: 1. Open the packaging boxes/crates and verify its contents. You should receive the AutoCAT 2 Series console and an accessory kit containing: ®...
Page 27: Ac Power
Use only Accessories supplied with the AutoCAT 2 Series pumps or meet specifications provided by ® Arrow International. Use of other accessories may not result in correct system operation. The DC circuit breaker was switched off at the factory to prevent damage to the AutoCAT 2 Series during shipping.
Page 28: Chapter 3 : P R I N C I P L E S O F O P E R A T I O N
3 . P r i n c i p l e s o f O p e r a t i o n C H A P T E R 3 : P r i n c i p l e s o f O p e r a t i o n Chapter 1 outlined the AutoCAT 2 Series and IABP indications.
Page 29 3 . P r i n c i p l e s o f O p e r a t i o n Inflate/Deflate Control Keys ........3-21 Trigger Control Keys .
Page 30: O V E R V I E W O F T H E A U T O C A T ® 2 S E R I E S
2 Series can interface with most bedside monitors and accepts ® inputs from patient cables and transducers. The AutoCAT ® 2 WAVE ® can accept input from a high fidelity AP source the FiberOptix™ sensor from Arrow IAB catheters with this option. Overview of AutoCAT ® 2 Series...
Page 31 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 1 : O v e r v i e w o f t h e A u t o C A T ®...
Page 32: Series Iabp System Configuration
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 1 : O v e r v i e w o f t h e A u t o C A T ®...
Page 33: Autocat ® 2 Series Control Module
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 1 : O v e r v i e w o f t h e A u t o C A T ®...
Page 34: Autocat ® 2 Series Display And Function Keys
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 1 : O v e r v i e w o f t h e A u t o C A T ®...
Page 35 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 1 : O v e r v i e w o f t h e A u t o C A T ®...
Page 36 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 1 : O v e r v i e w o f t h e A u t o C A T ®...
Page 37: Patient Connections
These are the connectors for the FiberOptix ™ AP Sensor and CAL Key. NOTE: These connections may only be used with FiberOptix Series Arrow IAB ™ catheters. Patient Connections 3-10...
Page 38: Storage Compartment
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 1 : O v e r v i e w o f t h e A u t o C A T ®...
Page 39: Pneumatic Drive Module
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 1 : O v e r v i e w o f t h e A u t o C A T ®...
Page 40: Strip Chart Recorder
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 1 : O v e r v i e w o f t h e A u t o C A T ®...
Page 41: I N P U T A N D O U T P U T C O N N E C T I O N
The CAL Key is provided with each FiberOptix ™ Series Arrow IAB catheter. Three Patient Signal outputs are available for ECG, AP and BPW. The Assist Interval output provides a signal output to a simulator for use during training or testing. Pump information is available via the modem or RS232 serial output, and the Model 2001 simulator may be connected to the Simulator Connection.
Page 42: Input Connections
2 Series. Some monitors require special modules to output this information. Be sure you have the correct equipment and cables available. CAUTION Only Fiber Optic sensors provided with Arrow International IAB catheters should be used with the AutoCAT ® 2 WAVE ®...
Page 43: Input Connectors
(AutoCAT 2 WAVE only) connector attached to the IAB with the arrow facing outward and slide ® ® the connector into the grooves. The connector will only fit one way. Slide the connector into the receptacle and press the connector until it clicks.
Page 44: Data/Output Connections
The input labeled BALLOON connects the IAB’s helium supply line to the AutoCAT ® Series. The AutoCAT 2 Series accepts Arrow International’s electronically-coded ® balloon connectors, which automatically set pumping volume to match the balloon’s maximum volume capacity. This connector also limits the amount of helium which can be delivered to the IAB to the IAB’s maximum volume.
Page 45: C O N T R O L K E Y S A N D F U N C T I O N K E Y
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Function Control Keys The AutoCAT ®...
Page 46: Autopilot /Operator Control Keys
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n s K e y s AutoPilot /Operator Mode Control Keys ™...
Page 47: Autopilot Automatic Timing Selection
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Timing method description: AutoPilot ™...
Page 48: Inflate/Deflate Control Keys
INFLATE Adjusts the inflation point (seen as a green or red bar at the bottom of the LCD); inflation occurs later when the right arrow is depressed and earlier when the left arrow is depressed; allows operator to optimize timing by monitoring the hemodynamic changes produced on the AP waveform.
Page 49: Trigger Control Keys
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Trigger Keys AutoPilot ™...
Page 50: Trigger Control Key Functions
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Trigger Control Key Functions Control Key Description...
Page 51 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Internal trigger mode selection •...
Page 52: Arrhythmia Timing Key
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Arrhythmia Timing Selections Arrhythmia Timing Control Key (AutoPilot ™...
Page 53 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s When R-WAVE DEFLATION is OFF, the pump will select the trigger/timing mode based on the ARRHYTHMIA TIMING setting and whether the patient has an arrhythmia.
Page 54: Pump Status
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Pump Status AutoPilot ™...
Page 55: Signal Input Selection
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Signal Input Selection ECG Signal Source AutoPilot...
Page 56: Ecg Select
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s CAUTION Do not use a 3 lead ECG cable or Phono to Nicolay slave cables.
Page 57: Ecg Gain Control
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s ECG Gain Control —...
Page 58: Ap Signal Source Select
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s AP Signal Source Select AutoPilot ™...
Page 59: Ap Autoscaling
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s AP Autoscaling: ON (Default setting) (AutoPilot ™...
Page 60 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Zero and CAL Function: AP Transducer 1.
Page 61: Ap Alarm
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s SELECTING THE AP PARAMETER FOR ALARM AND SETTING THE ALARM LIMIT Once the AP alarm is on, Multifunction key 3 can be used to select either the MAP or...
Page 62 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s ALARM CONDITIONS When the MAP or AUG is below the alarm limit for a specified period of time, a Class 3 Alert will sound and the following message will be displayed:...
Page 63: Assist Ratio
Counterpulsation is usually initiated in a 1:1 ratio in AutoPilot ™ Using the left or right arrow keys you can choose your selection. The ASSIST RATIO can be selected in either direction. The LED for the selected ASSIST RATIO will be illuminated.
Page 64: Balloon Volume
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Balloon Volume AutoPilot and Operator Modes:...
Page 65 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s CAUTION If IABP volume is changed while pumping patient support will be momentarily suspended as the volume is updated.
Page 66: Recorder Control Keys
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Recorder Control Keys AutoPilot ™...
Page 67: Alarms Off Time (Minutes) Selections
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Alarm Control Keys - AutoPilot ™...
Page 68: Alarm Control Keys
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Alarm Control Keys Selection Description...
Page 69: Multiple Alarm Handling
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Multiple Alarm Handling Multiple alarm conditions can occur.
Page 70: Alarm Messages
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s ALARM MESSAGES (Class I) Alarm Message Description...
Page 71 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s ALARM MESSAGES (Class II) Alarm Message Description...
Page 72 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s ALARM MESSAGES (Class III) Alarm Message Description...
Page 73: Autocat Fiberoptix
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s ALARM MESSAGES (Class III) –...
Page 74 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s ALARM MESSAGES (Class IV) Alarm Message Description...
Page 75: Cursor
2 Series has a horizontal cursor. This cursor will allow specific measurements of the Arterial Pressure Waveform or of the Balloon Pressure Waveform. The cursor may be moved by pressing the arrow key in the cursor section. The ˆ ˇ...
Page 76: Help
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Help - AutoPilot ™...
Page 77: Display Control
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Display Control - AutoPilot and Operator Modes ™...
Page 78: Home
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Home - AutoPilot ™...
Page 79: Recorder Setup
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Recorder Setup RECORDER SETUP...
Page 80: Weaning Setup
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : B a l l o o n I n f l a t i o n a n d D e f l a t i o n C o n t r o l s Weaning Setup WEANING In addition to the use of the Assist Ratio and Balloon Volume keys on the AutoCAT...
Page 81 3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : B a l l o o n I n f l a t i o n a n d D e f l a t i o n C o n t r o l s STOP WEANING Weaning can be suspended or terminated in several ways.
Page 82: Show/Hide Stats
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : B a l l o o n I n f l a t i o n a n d D e f l a t i o n C o n t r o l s Show/Hide Stats SHOW/HIDE STATS...
Page 83: Audio Setup
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : B a l l o o n I n f l a t i o n a n d D e f l a t i o n C o n t r o l s Audio Setup AUDIO SETUP...
Page 84: Hemodynamic Calculations (Hemo Calcs)
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : C o n t r o l K e y s a n d F u n c t i o n K e y s Hemodynamic Calculations (Hemo Calcs) HEMO- DYNAMICS...
Page 85: Clock Setup
3 . P r i n c i p l e s o f O p e r a t i o n 3 . 3 : B a l l o o n I n f l a t i o n a n d D e f l a t i o n C o n t r o l s Clock Setup CLOCK SETUP...
Page 86: Conventional Timing Real Time Timing Timing During Arrhythmia's In Autopilot
4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g C H A P T E R 4 : P r i n c i p l e s a n d A p p l i c a t i o n o f C o u n t e r p u l s a t i o n T i m i n g , T r i g g e r i n g , A s s i s t R a t i o a n d B a l l o o n V o l u m e This chapter will review the concepts and application of IABP counterpulsation including, control of assist ratio, balloon volume, timing principles, timing assessment...
Page 87: Assist Ratio
4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g 4 . 1 : A s s i s t R a t i o Assist Ratio Assist ratio settings are used to control balloon inflation and deflation frequency.
Page 88: Balloon Volume
All 30, 40 and 50 cc connectors with Arrow, Kontron or AVCO will be properly recognized. DO NOT USE connectors other than the 30, 40 and 50 cc connectors with KONTRON, AVCO or ARROW markings, these may NOT be properly recognized and may result in an incorrect balloon volume setting.
Page 89: Triggering
4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g 4 . 3 : T r i g g e r i n g Triggering The trigger mode selected, determines the criteria that the AutoCAT ®...
Page 90: Trigger Selection In Autopilot
4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g 4 . 3 . 1 : T r i g g e r S e l e c t i o n i n A u t o P i l o t ™...
Page 91: Trigger Selection In Operator Mode
ECG Triggering: In general the R wave is used as the trigger source, since it usually has a more consistent morphology than other patient signals. There are 5 ECG trigger modes on the AutoCat 2 series IABP’s. The criteria for each is described in detail in Section 3.3. CAUTION Do not use V Pace trigger mode with A Paced rhythms, improper timing may result.
Page 92 4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g 4 . 3 . 2 : T r i g g e r s e l e c t i o n i n O p e r a t o r M o d e Internal Trigger Mode: If the patient has no myocardial activity at all (e.g., during bypass surgery), inflation and deflation can be generated using the INTERNAL trigger mode.
Page 93: Timing
4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g 4 . 4 : T i m i n g Timing Timing refers to a computer controlled or operator controlled action which varies the inflate and deflate points of the IAB relative to the trigger cycle.
Page 94: The Ap Waveform With Proper Real Time Timing
4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g 4 . 4 : T i m i n g Real time timing: requires balloon inflation to occur simultaneously with AVC and deflation to occur at the R wave or during Isovolumetric contraction (IVC).
Page 95 4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g 4 . 4 : T i m i n g Specialized Timing during Arrhythmia’s in AutoPilot ™...
Page 96: Autocat 2 Wave
4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g 4 . 4 : T i m i n g AutoCAT ®...
Page 97 4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g 4 . 4 : T i m i n g When R-Wave deflation is ON, the pump will select AFIB trigger mode, which uses R-Wave deflation.
Page 98 RATIO section of the keypad, to select 1:2. Adjust the inflation point: • Depress the "LATE" > arrow of the inflate control key until you can clearly see the DN on the AP waveform. • Depress the < "EARLY" arrow of the inflate control key until the white overlay is at the beginning of DN (40ms in front of DN) and the DN is no longer visible when pumping.
Page 99: Timing Errors
AVC, thus reducing Stroke Volume (SV). If inflation occurs very early, some blood may be regurgitated into the left ventricle. If the AP waveform shows early inflation, depress the "LATE" > arrow of the INFLATE CONTROL key to set a new inflation point closer to the DN.
Page 100: Late Inflation
SYS: cardiac workload has not been reduced. On the waveform, ASYS does not show the effect of afterload reduction, and Assisted DIA is shallow and returns to the baseline pressure. Depress the "LATE" > arrow of the deflate control key and observe the reduction in Assisted SYS.
Page 101: Timing Assessment
Prolonged systolic rise time. Timing Assessment in Operator Mode. • After you have achieved optimum timing, press the left arrow key in the ASSIST RATIO section of the keypad, until 1:1 is selected. Now every heart beat will be assisted.
Page 102 0% __________50% __________80% __________120% EXAMPLE 2: If the patient’s heart rate were to increase, necessitating a change in inflation timing, the operator would depress the right arrow on the inflate control key. 0% ________________75% ____80% __________120% 3 In the APACER mode, the R-R interval displayed is delayed by 100ms from trigger point because of the relationship between the atrial pacing spike and the cardiac cycle.
Page 103 4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g 4 . 4 : T i m i n g EXAMPLE 3: Continued changes to the inflate setting will affect a corresponding change in the deflate setting to maintain a 5% difference between inflation and deflation.
Page 104: Chapter 5 : O P E R A T I N G P R O C E D U R E S : A U T O P I L O T ™ M O D E
2 Series IABP System, refer to Chapter 8, Troubleshooting, which provides troubleshooting guidelines and refers you to the 24 hour telephone number for Arrow International service. This chapter will review start up and operation when the AutoPilot mode is selected.
Page 105: Operating Instructions
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s Operating Procedures Operating Instructions Summary...
Page 106: Summary Of Start-Up Instructions For Autopilot ™ Mode
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s These preset selections are clinically appropriate for most patient situations and allow startup to occur rapidly, simply, effectively and safely.
Page 107 5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s AUTOPILOT MODE ACTION DETAILS...
Page 108: Preparation
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s Detailed Operations in AutoPilot ™...
Page 109: Selecting The Operations Mode
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s 2.
Page 110: Ecg Connections
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s FRONT VIEW OF ELECTRODES X X X X X V-LEADS...
Page 111: Ecg Connections
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s •...
Page 112 5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s Lightly tap each electrode contact with your finger while observing the ECG trace on the LCD.
Page 113: Arterial Pressure Connections
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s 4.
Page 114: Connecting Iab
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s CAUTION The FiberOptix ™...
Page 115: Initiating Counterpulsation
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s Verify Triggering Check HR Check White markers on ECG...
Page 116: Properly Timed Arterial Pressure Waveform
A properly coded balloon connector should be used with all balloons, including those not manufactured by Arrow International. Using a balloon connector coded for a volume greater than that of the balloon can have serious clinical consequences and is not recommended. Verify balloon volume prior to operating the pump, as described in section 5.1.
Page 117: Verify Alarms On
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s 10.
Page 118: Maintaining Balloon Pumping
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s Maintaining Balloon Pumping The AutoCAT ®...
Page 119: Freezing And Recording Waveforms
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s WARNING This device is frequently used in acute stages of cardiac failure.
Page 120: Battery Operation
5 . O p e r a t i n g P r o c e d u r e s 5 . 1 : O p e r a t i n g I n s t r u c t i o n s •...
Page 121: The Autocat
Clinical Environments When AutoPilot ™ mode is selected the operation of the AutoCat 2 Series is largely automatic. The following sections contain some tips for pump operation in the ICU, OR, Cath Lab, during transport, weaning and for emergency start-up.
Page 122 5 . O p e r a t i n g P r o c e d u r e s 5 . 2 : C l i n i c a l E n v i r o n m e n t s 6.
Page 123: Series In Emergency Conditions
5 . O p e r a t i n g P r o c e d u r e s 5 . 2 : C l i n i c a l E n v i r o n m e n t s Figure 5.5: Placement of ECG and ESU Cables NOTE: A 5 lead (IAA-04305) NDM/ConMed back pad electrode and cable is available for use in these environments.
Page 124: Autocat ® 2 Series Transport
AutoCAT ® 2 Series is always ready to go where ever and whenever it is needed. In addition Arrow International provides a specially designed transport unit, the Aero AutoCAT ® 2 Series. This pump has the same functions as the standard AutoCAT ®...
Page 125 5 . O p e r a t i n g P r o c e d u r e s 5 . 2 : C l i n i c a l E n v i r o n m e n t s Air Transport with FiberOptix ™...
Page 126 5 . O p e r a t i n g P r o c e d u r e s 5 . 2 : C l i n i c a l E n v i r o n m e n t s •...
Page 127 • At the receiving hospital, establish baseline hemodynamic data just before and immediately after console exchange. NOTE: When the AUTOCAT 2 SERIES is running in battery, a warning message "ON BATTERY" is continuously displayed above the ECG trace. This message will clear when AC power is re-established.
Page 128: Weaning The Patient
Weaning by decreasing the frequency: 1. Press the right > arrow ASSIST key in the ASSIST RATIO section of the keypad to set the assist ratio from 1:1 to 1:2. 2. As the patient condition warrants, decrease the assist ratio to 1:4, then optionally 1:8.
Page 129 5 . O p e r a t i n g P r o c e d u r e s 5 . 2 : C l i n i c a l E n v i r o n m e n t s Setup of Automatic Weaning Protocol In addition to the use of the Assist Ratio and Balloon Volume keys on the AutoCAT ®...
Page 130 WEANING STEP COMPLETE EVALUATE HEMODYNAMICS AND CONTINUE WEANING OR RESUME FULL IABP SUPPORT Current IAB volume and assist ratio from the weaning setup will be used for pumping until another weaning setup is selected or until pumping is discontinued. NOTE: IAB volume cannot be reduced more than 50% of the IAB connector volume in the weaning setup.
Page 131: Chapter 6 : O P E R A T I N G P R O C E D U R E S : O P E R A T O R M O D E
2 Series IABP System, refer to Chapter 8, Troubleshooting, which provides troubleshooting guidelines and refers you to the 24 hour telephone number for Arrow International service. This chapter will review start up and operation when the Operator mode is selected. The contents of this chapter include: 6 .
Page 132: O P E R A T I N G I N S T R U C T I O N S
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s Summary The steps to initiate and maintain counterpulsation in the Operator mode are briefly summarized below.
Page 133: Summary Of Start-Up Instructions For Operator Mode
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s Summary of Start-up Instructions for Operator mode: Ensure that you have sufficient power, helium, recorder paper and other supplies.
Page 134 6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s OPERATOR MODE ACTION DETAILS...
Page 135: Preparation
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s Detailed Operations in Operator mode: Preparation The Operational Checkout procedure described in Section 10.1 is designed to verify the...
Page 136: Selecting The Operations Mode
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s 2.
Page 137: Ecg Connections
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s Patient Connections FRONT VIEW OF ELECTRODES X X X X X...
Page 138: Ecg Connectors
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s Figure 6.2: ECG Connectors Confirm that ECG leads RA, LA, RL, LL and V are correctly connected to the 5 lead patient cable.
Page 139 6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s High Level Monitor Connection •...
Page 140 6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s CAUTION The FiberOptix™...
Page 141: Choosing A Trigger Mode
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s 5.
Page 142 6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s Recommended IABP Triggers Rhythm Pattern...
Page 143: Verify Reliable Triggering
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s An Automatic Response alarm will alert you if the AutoCAT ®...
Page 144: Optimizing Inflation/Deflation Timing
ASSIST RATIO section of the keypad, until 1:2 is selected. Adjust the inflation point: • Depress the ">" arrow of the inflate control key until you can clearly see the DN on the AP waveform. • Depress the <"EARLY" arrow of the inflate control key until the white overlay is at the beginning of DN (40ms in front of DN) and the DN is no longer visible when pumping.
Page 145: Assessing The Balloon Pressure Waveform
6 . 1 : O p e r a t i n g I n s t r u c t i o n s • After you have achieved optimum timing, press the left arrow key in the ASSIST RATIO section of the keypad, until 1:1 is selected.
Page 146: Verify Alarms On
A properly coded balloon connector should be used with all balloons, including those not manufactured by Arrow International. Using a balloon connector coded for a volume greater than that of the balloon can have serious clinical consequences. Verify balloon volume prior to operating the pump, as described in section 5.1.
Page 147 6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s •...
Page 148: Maintaining Balloon Pumping
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s Maintaining Balloon Pumping The AutoCAT 2 Series operator mode automatically adjusts timing for most heart rate...
Page 149: Freezing And Recording Waveforms
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s Freezing and Recording Waveforms At any time during IABP operation, you can freeze the LCD or use the strip chart recorder to record waveforms and hemodynamic data.
Page 150: Battery Operation
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s Battery Operation The AutoCAT 2 series will run for 90 minutes on the standard battery and up to...
Page 151: The Autocat
6 . O p e r a t i n g P r o c e d u r e s 6 . 1 : O p e r a t i n g I n s t r u c t i o n s The AutoCAT ®...
Page 152: The Autocat
6 . O p e r a t i n g P r o c e d u r e s 6 . 2 : C l i n i c a l E n v i r o n m e n t s The AutoCAT ®...
Page 153 ® 2 Series may come from a variety of sources. These include a high fidelity Fiber Optic sensor (FiberOptix ™ ) source in an Arrow IAB catheter, transducers or from monitors. The FiberOptix ™ sensor can be used with AutoCAT 2 WAVE IABP systems only.
Page 154: C A L I B R A T I O N O F T R A N S D U C E R S
® only) The FiberOptix sensor uses light to measure the AP pressure. This sensor is available in ™ some Arrow IAB catheters and can be used with the AutoCAT ® 2 WAVE ® IABP only. If you have an IAB with the Fiber Optic pressure sensor, the following sections will guide you through set-up, connection and zeroing of the sensor.
Page 155 FiberOptix ™ sensor system is not suitable for use in the presence of flammable anesthetics. WARNING Only Fiber Optic sensors provided with Arrow International IAB catheters should be used with the AutoCAT ® 2 WAVE ® . Use of other Fiber optic sensors may cause damage to the IABP system or produce inaccurate AP readings.
Page 156 7 . C a l i b r a t i o n P r o c e d u r e s 7 . 1 : C a l i b r a t i o n o f T r a n s d u c e r s When the autozero is complete a 4 beep audible tone will be issued and the following message will be displayed: FOS SENSOR ZEROED...
Page 157 7 . C a l i b r a t i o n P r o c e d u r e s 7 . 1 : C a l i b r a t i o n o f T r a n s d u c e r s AP FOS Light Bulb Icon The AP FOS icon (light-bulb) is used to indicate the Zeroing, connection and readiness status of the sensor.
Page 158 The AP source should be verified for accuracy as well. Zeroing and Calibrating a Transducer or Monitor Input The Zero and Calibration functions of the AutoCat 2 series IABP have been simplified. Use the following procedure to Zero and/or calibrate a Transducer or MON input signal.
Page 159 7 . C a l i b r a t i o n P r o c e d u r e s 7 . 1 : C a l i b r a t i o n o f T r a n s d u c e r s Calibrating an AP Transducer You must calibrate reusable transducers prior to initiating counterpulsation.
Page 160 When XDUCER CAL is pressed the following options will appear: XDUCER RESET APPLY XDUCER ALARM ALARM SCALING ZERO ON/OFF ON/OFF • Press RESET CAL • Verify message reads “PRESS RESET CAL AGAIN TO RESTORE DEFAULT CAL LEVEL” • Press RESET CAL again and confirm the message reads: “AP RESET TO 100MMHG/VOLT”...
Page 161: Changing The Display Range
Changing the Display Range (AP Scaling) • AutoScaling ON: When AP autoscaling is ON, the IABP will automatically select the AP scale that fully displays the AP waveform. AP scaling updates approximately every 15 seconds. Autoscaling is ON at pump start-up NOTE: The AP numeric values will not change due to changes in the display scale.
Page 162: Chapter 8 : T R O U B L E S H O O T I N G
This will reduce the risk of thrombus formation, but should be used only as an emergency procedure for short periods of time while awaiting the physician’s arrival. The physician should consider removing the balloon. Arrow International recommends that you have a back-up IABP system available in case of a pump shutdown.
Page 163: Common Operational Problems
Leak Testing procedure described in section 8.4. If you are unable to correct EMI or any other problem with your system, call your local Arrow International Field Service Representative or call our 24-hour IABP service hotline 1-800-447-IABP (4227) or 1- 617-389-8628 (outside the U.S.A.
Page 164: Common Operational Problems In Autopilot
Defective waveform Use the strip chart recorder or an display external monitor connected to the ECG output connector to monitor ECG; call Arrow International for service Incorrect ECG Source selected Check ECG signal source LED. Change source by pressing SELECT key.
Page 165 Defective transducer Replace pressure transducer Defective amplifier Use external AP monitor connected to the AP input connector to monitor Arterial Pressure; call Arrow International for service Incorrect source selected Check AP signal source LED. Change source by pressing SELECT key.
Page 166: Common Operational Problems In Autopilot
8 . T r o u b l e s h o o t i n g 8 . 1 : C o m m o n O p e r a t i o n a l P r o b l e m s COMMON OPERATIONAL PROBLEMS Problem Possible Cause(s)
Page 167: Troubleshooting Fiberoptix
8 . T r o u b l e s h o o t i n g 8 . 1 : C o m m o n O p e r a t i o n a l P r o b l e m s Section 1 Troubleshooting the FiberOptix ™...
Page 168 8 . T r o u b l e s h o o t i n g 8 . 1 : C o m m o n O p e r a t i o n a l P r o b l e m s FOS Status Codes (continued) Status Code Description...
Page 169 8 . T r o u b l e s h o o t i n g 8 . 1 : C o m m o n O p e r a t i o n a l P r o b l e m s Section 3 Troubleshooting Zeroing Issues with the FOS System If the FOS sensor is unable to Zero the following information will assist in troubleshooting: The display will show “UNABLE TO AUTOZERO FOS”...
Page 170: Fiberoptix
8 . T r o u b l e s h o o t i n g 8 . 1 : C o m m o n O p e r a t i o n a l P r o b l e m s Section 4 Fiber Optic General Troubleshooting Information This section shows symptoms that may occur when using the Fiber optic system.
Page 171: Fiberoptix General Troubleshooting
8 . T r o u b l e s h o o t i n g 8 . 1 : C o m m o n O p e r a t i o n a l P r o b l e m s FiberOptix ™...
Page 172: Troubleshooting Esis
8 . T r o u b l e s h o o t i n g 8 . 1 : C o m m o n O p e r a t i o n a l P r o b l e m s ESIS ESlS minimizes the interference problems caused by electrosurgical/cautery devices.
Page 173: Troubleshooting Esis
8 . T r o u b l e s h o o t i n g 8 . 1 : C o m m o n O p e r a t i o n a l P r o b l e m s TROUBLESHOOTING ESIS Problem Possible Cause(s)
Page 174: Automatic Response Alarms
8 . T r o u b l e s h o o t i n g 8 . 2 : D i a g n o s t i c A l a r m s 8.2 Diagnostic Alarms The AutoCAT 2 Series alarm system notifies you of certain potential or actual problems ®...
Page 175 8 . T r o u b l e s h o o t i n g 8 . 2 : T r o u b l e s h o o t i n g A l a r m s C l a s s I AUTOMATIC RESPONSE ALARMS (Class I) Problem Operation Mode...
Page 176 8 . T r o u b l e s h o o t i n g 8 . 2 : T r o u b l e s h o o t i n g A l a r m s C l a s s I AUTOMATIC RESPONSE ALARMS (Class I) Problem Operation Mode...
Page 177 Partially wrapped balloon Notify physician; aspirate IAB, if no blood is present inject 50cc of air into the balloon and aspirate immediately. Overfill Call Arrow International for service Improper IAB position Verify IAB position and reposition as needed. Large Helium Leak...
Page 178 8 . T r o u b l e s h o o t i n g 8 . 2 : T r o u b l e s h o o t i n g A l a r m s C l a s s I / I I AUTOMATIC RESPONSE ALARMS (Class I) Problem Operation Mode...
Page 179 8 . T r o u b l e s h o o t i n g 8 . 2 : T r o u b l e s h o o t i n g A l a r m s C l a s s I I AUTOMATIC RESPONSE ALARMS (Class II) Problem Operation Mode...
Page 180 8 . T r o u b l e s h o o t i n g 8 . 2 : T r o u b l e s h o o t i n g A l a r m s C l a s s I I AUTOMATIC RESPONSE ALARMS (Class II) Problem Operation Mode...
Page 181: Information Only Alarms
8 . T r o u b l e s h o o t i n g 8 . 2 : T r o u b l e s h o o t i n g A l a r m s C l a s s I I / I I I INFORMATION ONLY ALARMS (Class III) Problem Operation Mode...
Page 182 8 . T r o u b l e s h o o t i n g 8 . 2 : T r o u b l e s h o o t i n g A l a r m s C l a s s I I I INFORMATION ONLY ALARMS (Class III) Problem Operation Mode...
Page 183 8 . T r o u b l e s h o o t i n g 8 . 2 : T r o u b l e s h o o t i n g A l a r m s C l a s s I V INFORMATION ONLY ALARMS (Class III) Problem Operation Mode...
Page 184 8 . T r o u b l e s h o o t i n g 8 . 3 : B a l l o o n P r e s s u r e W a v e f o r m AUTOMATIC ALERTS ALARMS (Class IV) Problem Operation Mode...
Page 185: Squared Waveform
8 . T r o u b l e s h o o t i n g 8 . 3 : B a l l o o n P r e s s u r e W a v e f o r m 8.3 Balloon Pressure Waveform The balloon pressure waveform displayed on the AutoCAT 2 LCD represents the dynamic...
Page 186: Reduced Augmentation
8 . T r o u b l e s h o o t i n g 8 . 3 : B a l l o o n P r e s s u r e W a v e f o r m 2.
Page 187: Baseline Below Zero
8 . T r o u b l e s h o o t i n g 8 . 3 : B a l l o o n P r e s s u r e W a v e f o r m 5.
Page 188 If a helium leak is suspected, follow the instructions below to check the pneumatics and the balloon connector. You will need a pair of rubber-shod hemostats and a spare balloon connector and tubing to perform the Leak Test. Call your Arrow International Sales Representative or service number for ordering information.
Page 189 8 . T r o u b l e s h o o t i n g 8 . 4 : L e a k T e s t i n g a n d T u b i n g R e p a i r s Tubing Repairs 1.
Page 190: Chapter 9 : O P E R A T I O N A L P R E C A U T I O N S , L I M I T A T I O N S A N D H A Z A R D S
WARNING Use only Accessories supplied with the AutoCAT 2 Series pumps ® (page 2-5) or meet specifications provided by Arrow International. Use of other accessories may not result in correct system operation. Operational Precautions, Limitations and Hazards...
Page 191 9 . O p e r a t i o n a l P r e c a u t i o n s , L i m i t a t i o n s a n d H a z a r d s 9 .
Page 192 A properly coded balloon connector should be used with all (page 5-13 and 6-16) balloons, including those not manufactured by Arrow International. Using a balloon connector coded for a volume greater than that of the balloon can have serious clinical consequences.
Page 193 9 . O p e r a t i o n a l P r e c a u t i o n s , L i m i t a t i o n s a n d H a z a r d s 9 .
Page 194 The FiberOptix ™ system is not suitable for use in the presence of flammable anesthetics. Only Fiber Optic sensors provided with Arrow International IAB catheters should be used with the AutoCAT ® 2 WAVE ® Use of other Fiber optic sensors may cause damage to the IABP system or produce inaccurate AP readings.
Page 195 15-30 minutes, manually inflate and deflate the IAB several times per hour to reduce the risk of thrombus formation. Consider removing the balloon. Arrow International recommends that you have a back-up IABP system available. WARNING A fully charged battery will power the AutoCAT ®...
Page 196 (page 4-3) connector will be properly recognized. All 30, 40 and 50 cc connectors with Arrow, Kontron or AVCO will be properly recognized. DO NOT USE connectors other than the 30, 40 and 50 cc connectors with KONTRON, AVCO or ARROW markings, these may NOT be properly recognized and may result in an incorrect balloon volume setting.
Page 197 9 . O p e r a t i o n a l P r e c a u t i o n s , L i m i t a t i o n s a n d H a z a r d s 9 .
Page 198 CAUTION Panel covers should not be removed by anyone other than (page 10-1) Arrow International Field Service Engineers or their authorized representatives. Shock hazards exist when the protective covers are removed. CAUTION Do not clean the AutoCAT ®...
Page 199 High pressure gas canisters should be handled by trained (page 10-9) personnel only. CAUTION Use only the fuse type and rating specified. Call Arrow (page 10-11) International’s service number for assistance. Panel covers should not be removed by anyone other than Arrow International Field Service Engineers or their authorized representatives.
Page 200 Chapter 8 contains troubleshooting tables to help you identify and correct problems quickly. If you are unable to correct a problem with your system, call your Arrow International Representative or the Product Support Line for assistance.
Page 201 International, Inc. service organization operates 24 hours a day. CAUTION Panel covers should not be removed by anyone other than Arrow International Field Service Engineers or their authorized representatives. Shock hazards exist when the protective covers are removed. The contents of this chapter include: R o u t i n e M a i n t e n a n c e P r o c e d u r e s .
Page 202: Series System Maintenance Schedule
® 2 Series System Maintenance Schedule This schedule provides an outline of the frequency that Arrow International recommends the following routine maintenance and service procedures be performed. The procedures listed as being in the Operator’s Manual can be performed by the operator of the AutoCAT ®...
Page 203: Operational Checkout
The system should also be checked prior to its anticipated use to allow sufficient time to correct any problem found. The procedures listed in the Service Manual section should only be performed by Arrow International Field Service Representatives or representatives or Biomedical personnel who have been trained in the proper servicing of Arrow International Intra-Aortic Balloon pump systems.
Page 204 • Observe the helium supply reading on the LCD again. Note any rapid pressure drops or variations. If you note any pressure variations after reinserting the helium tank, call your Arrow International Field Service Representative for assistance. (see section 2.1) 6. Select the INTERNAL trigger mode: • Select Operator Mode. Press Trigger.
Page 205 LCD will change. Note that the numbers change corresponding to the new Inflate/Deflate settings. 8. Connect an Arrow International hydraulic load simulator (P/N IAT-00025) to the BALLOON CONNECTOR outlet located above the power switch on the front of the AutoCAT 2 Series console.
Page 206: Cleaning And Disinfection
5. Plug the power cord back into an active, properly grounded AC power source. 6. Dispose of IABP accessories in compliance with government regulations and/or hospital regulations. Contact Arrow International for questions regarding disposal of specific IABP accessories or pump systems.
Page 207: Condensate Removal
1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 1 : R o u t i n e M a i n t e n a n c e P r o c e d u r e s Condensate Removal Check the condensate bottle with every use and empty whenever it becomes full.
Page 208: Recorder Paper Installation
1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 1 : R o u t i n e M a i n t e n a n c e P r o c e d u r e s Recorder Paper Installation The recorder uses rolls of blank 50mm thermal-sensitive paper.
Page 209: Helium Tank Replacement
1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 1 : R o u t i n e M a i n t e n a n c e P r o c e d u r e s Helium Tank Replacement The helium tank should be replaced when “LOW HELIUM SUPPLY”...
Page 210: Helium Tank Installation With Disposable Tank
1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 1 : R o u t i n e M a i n t e n a n c e P r o c e d u r e s Refillable >2000 psi He tank - a.
Page 211: Fuse Replacement
See Section 10.3 for ordering information. Part numbers for the fuses can be found in Section 10.3. CAUTION Use only the fuse type and rating specified. Call Arrow International’s service number for assistance. CAUTION Panel covers should not be removed by anyone other than Arrow International Field Service Engineers or their authorized representatives.
Page 212: Sealed Lead Acid Battery Maintenance
-recycling symbol -Arrow part number for the battery -lead contents in % -disposition instructions 1. The battery should be maintained at full charge whenever possible. Arrow International recommends that the AutoCAT 2 Series IABP System be kept plugged ® into a proper AC receptacle whenever possible including time when the unit is in storage or not in use.
Page 213 However, to insure the highest level of reliability, Arrow International recommends that the batteries be replaced after three years of service. As the batteries age, it is important that their performance be periodically checked to insure that they will perform as intended.
Page 214: Battery Load Test
Power down the AutoCAT 2 Series and notify qualified service personnel. ® 3. Attach an Arrow Hydraulic Load Simulator or other proper load device to the balloon connector of the AutoCAT ® 2 Series. Install a helium cylinder with at least 100 psi of pressure.
Page 215: Battery Replacement Procedure
1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 2 : S e r v i c e M a i n t e n a n c e P r o c e d u r e s Battery Replacement Procedure 1.
Page 216: Fos Cleaning
Tech Tip 77-001, which can be found in the AutoCAT ® 2 Series Service Manual (PN IAM-9008) or may be obtained from Arrow International Field Service. FOS Slide Connector Interface Replacement The interface connection housed in the FOS slide connector of the AutoCAT 2 WAVE ®...
Page 217: Service Information
If the AutoCAT ® 2 Series requires preventive or corrective maintenance service, or if you need assistance with an operational problem, call your Arrow International Field Service Representative. You can receive clinical/technical assistance 24 hours a day by calling: 1-800-447-IABP (4227) (U.S.A. & Canada) 1-617-389-8628 (outside the U.S.A.
Page 218: Ordering Information
1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 3 : S e r v i c e a n d O r d e r i n g I n f o r m a t i o n ORDERING INFORMATION Name Catalog Number...
Page 219 1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 3 : S e r v i c e a n d O r d e r i n g I n f o r m a t i o n ORDERING INFORMATION Name Catalog Number...
Page 220 1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 3 : S e r v i c e a n d O r d e r i n g I n f o r m a t i o n ORDERING INFORMATION Name Catalog Number...
Page 221 1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 3 : S e r v i c e a n d O r d e r i n g I n f o r m a t i o n ORDERING INFORMATION Name Catalog Number...
Page 222: Aero Autocat ® 2 Iabp Console
1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 3 : S e r v i c e a n d O r d e r i n g I n f o r m a t i o n ORDERING INFORMATION Name Catalog Number...
Page 223 1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 3 : S e r v i c e a n d O r d e r i n g I n f o r m a t i o n ORDERING INFORMATION Name Catalog Number...
Page 224 1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 3 : S e r v i c e a n d O r d e r i n g I n f o r m a t i o n ORDERING INFORMATION Name Catalog Number...
Page 225 Load simulator IAT-00025 Load simulator to simulate IAB attached to AutoCAT ® Series IABP system. Universal IAT-00030 Load simulator to simulate IAB attached to Arrow IABP IABP Volume systems. Provides calibrated fluid column to verify Calibration volume displacement. Simulator Model 2001...
Page 226 1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 3 : S e r v i c e a n d O r d e r i n g I n f o r m a t i o n ORDERING INFORMATION Name Catalog Number...
Page 227 1 0 . M a i n t e n a n c e a n d S e r v i c e 1 0 . 3 : S e r v i c e a n d O r d e r i n g I n f o r m a t i o n ORDERING INFORMATION Name Catalog Number...
Page 228 Balloon Pump against defects in materials and workmanship for a period of ONE (1) YEAR from the date of purchase. If ARROW receives notice of such defects during the warranty period, ARROW will, at its option for the original customer, repair or replace products which prove to be defective.
Page 229: Chapter 1 1 : P E R F O R M A N C E A N D T E C H N I C A L S P E C I F I C A T I O N S
1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s C H A P T E R 1 1 : P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s The AutoCAT ®...
Page 230 11-2...
Page 231: The Autocat
1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 232: Series Technical Specifications
1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 233: 1 . 1 : A U T O C A T ® 2 S E R I E S S P E C I F I C A T I O N S
1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 234: Trigger Selection Criteria
1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 235 1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 236 1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 237 1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 238 PC via phone line for remote system monitoring FLASH CARD PCMCIA standard for storing data or downloading custom setups FiberOptix ™ Sensor For connection of Arrow IAB Catheter with Fiber Optic Sensor (AutoCAT ® 2 WAVE ® only) Provides Fiber Optic Sensor information to IABP console...
Page 239: Autocat ® 2 Series Outside Labeling Information
1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 240: Series Symbols And Definitions
1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 241 1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 242 1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 243 1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 244 1 1 . P e r f o r m a n c e a n d T e c h n i c a l S p e c i f i c a t i o n s 1 1 .
Page 245 A p p e n d i x : C o m m o n A b b r e v i a t i o n s Many terms associated with the use of Intra-Aortic Balloon Pumping are referred to by their abbreviations.
Page 246 A p p e n d i x : C o m m o n A b b r e v i a t i o n s Heart Rate Intra-Aortic Balloon IABP Intra-Aortic Balloon Pump (or Intra-AorticBalloon Pumping) International Electrical Code Internal Trigger Mode Isovolumetric Contraction Isovolumetric Relaxation...
Page 247 A p p e n d i x H : H e l p T e x t KEY 1 KEY 2 KEY 3 HELP MESSAGE TEXT AUTOPILOT MODE HELP At Start Up 1. Connect ECG and AP signals 2. Connect balloon (No key press needed) Otherwise press 3.
Page 248 A p p e n d i x H : H e l p T e x t KEY 1 KEY 2 KEY 3 HELP MESSAGE TEXT AUTOPILOT MODE (continued) HELP ARR. Turns automatic arrhythmia timing ON TIMING or OFF in AUTOPILOT MODE ONLY. ON/OFF When Arr.
Page 249 A p p e n d i x H : H e l p T e x t KEY 1 KEY 2 KEY 3 HELP MESSAGE TEXT OPERATOR MODE (continued) HELP TRIGGER Selects Trigger in Operator mode MODE Automatic trigger selection in AutoPilot .
Page 250 A p p e n d i x H : H e l p T e x t KEY 1 KEY 2 KEY 3 HELP MESSAGE AND TEXT OPERATOR MODE (continued) TRIG- HELP ARTERIAL AP trigger mode PRESSURE (AP) Uses AP waveform to trigger. MODE Recommended when ECG is not available or too noisy.
Page 251 A p p e n d i x H : H e l p T e x t KEY 1 KEY 2 KEY 3 HELP MESSAGE AND TEXT MESSAGES WHICH ARE THE SAME IN AUTOPILOT AND OPERATOR MODES HELP ALARMS Turns alarms audio, recording, drain ON/OFF and refill on or off.
Page 252 KEY 1 KEY 2 KEY 3 HELP MESSAGE AND TEXT MESSAGES WHICH ARE THE SAME IN AUTOPILOT AND OPERATOR MODES HOME HELP SHOW STATUS Shows AutoCAT 2 Series operational ® status including DATE, POWER, ALARMS, RECORDER, HELIUM tank level and ASSIST RATIO. Press HIDE STATUS to clear display.
Page 253 A p p e n d i x : A p p l i c a b l e S t a n d a r d s Appendix – Applicable Standards IEC 60601-1 Medical Electrical Equipment - Part 1: General Requirements for Safety CSA C2.22 No.
Page 254 A p p e n d i x : A p p l i c a b l e S t a n d a r d s Conformance to Standards: STANDARD Table # (referenced to IEC 60601-1-2) CISPR 11 EN 55011 Table 201 IEC 61000-3-2 Table 201...
Page 255 A p p e n d i x : A p p l i c a b l e S t a n d a r d s Table 202 Guidance and manufacturer's declaration - electromagnetic immunity The AutoCAT 2 Series IABP is intended for use in the electromagnetic environment ®...
Page 256 A p p e n d i x : A p p l i c a b l e S t a n d a r d s Table 202 (continuced) Guidance and manufacturer's declaration - electromagnetic immunity Immunity test IEC 60601 Compliance Electromagnetic environment -...
Page 257 A p p e n d i x : A p p l i c a b l e S t a n d a r d s Table 204 Guidance and manufacturer's declaration - electromagnetic immunity The AutoCAT 2 Series is intended for use in the electromagnetic environment ®...
Page 258 A p p e n d i x : A p p l i c a b l e S t a n d a r d s Table 204 (continued) Guidance and manufacturer's declaration - electromagnetic immunity Immunity test IEC 60601 Compliance Electromagnetic environment -...
Page 259 A p p e n d i x : A p p l i c a b l e S t a n d a r d s Table 206 Recommended separation distances between portable and mobile RF communications equipment and the AutoCAT ®...
Page 260 G l o s s a r y Afterload The pressure which ventricular contraction must exceed to open the aortic valve; Aortic End-Diastolic Pressure Aortic Valve Closure The onset of diastole; signaled by the DN on the (AVC) AP waveform Aortic Valve Opening The onset of systole;...
Page 261 G l o s s a r y Dicrotic Notch The notch on the downslope of the AP waveform (DN) that signals AVC and the onset of diastole; caused by the backflow of blood as the pressure in the ventricle falls below that in the aorta Ejection The bolus of blood forced out of the heart and into the...
Page 262 G l o s s a r y Operator Mode The mode of pump operation where the user can control all pump functions Quality Assurance log Time stamped record of IABP operations including alarms, hemodynamics and operational settings Peak Diastolic Pressure The highest aortic pressure generated by balloon (PDP) also AUG inflation;...
Page 263 G l o s s a r y Timing Method The logic which determines how to set inflation and deflation timing Trigger The signal used by the IABP to activate the inflation/deflation cycle; signal may be patient-generated (ECG or AP) or control system-generated (INTERNAL) WAVE ®...
Page 264 R e f e r e n c e s 1 Armstrong B, Zidar JP, Ohman EM: The use of intra-aortic balloon counterpulsation in acute myocardial infarction and high risk coronary angioplasty. Journal Interventional Cardiology 8:185, 1995 2 Bauriedel G, Schwaiblmair M, Kreuzer E, et al: Percutaneous intra-aortic counterpulsation as a therapeutic option in cardiogenic shock.
Page 265 R e f e r e n c e s 15 Kern MJ, Aquirre FV, Bach R, Donohue T, Siegel R, Segal J: Augmentation of coronary blood flow by intra-aortic balloon pumping in patients after coronary angioplasty. Circulation 81:2, 500, 1993 16 Kern MJ, Aquirre FV, Tatineni S, Penick D, Serota H, Donohue T, Walter K: Enhanced coronary blood flow velocity during intra-aortic balloon counterpulsation in critically ill patients.
Page 266 R e f e r e n c e s 30 Reesink, K., Van der Nagel, T., Bovelander, J., Jansen, J., van der Veer, F, Schreuder, J.: Feasibility of a Fiber Optic System System for Invasive Blood Pressure Measurements. Catheterization and Cardiovascular Interventions, 2002; 57: 272-6.
Page 268 Reading, PA 19605, USA G R E E C E M E X I C O Phone: 610-378-0131 Arrow Hellas A.E.E. Arrow Internacional de Mexico S.A. de C.V. Toll-free: (800) 233-3187 230 Kifissias Avenue Moliere No. 128, Col. Polanco Fax: 610-374-5360...

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Autocat 2Autocat 2 wave

Arrow AutoCAT 2 Series Operating Manual

Chapter 2 : I N S T a L L a T I O N P R O C E D U R E S

Chapter 3 : P R I N C I P L E S O F O P E R a T I O N

Chapter 5 : O P E R a T I N G P R O C E D U R E S : a U T O P I L O T ™ M O D E

Chapter 6 : O P E R a T I N G P R O C E D U R E S : O P E R a T O R M O D E

Chapter 8 : T R O U B L E S H O O T I N G

Chapter 9 : O P E R a T I O N a L P R E C a U T I O N S , L I M I T a T I O N S a N D H a Z a R D S

Chapter 1 1 : P E R F O R M a N C E a N D T E C H N I C a L S P E C I F I C a T I O N S

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