CytoSorb TRAINING

CytoSorbents Europe GmbH

Bölschestraße 116, 12587 Berlin

fon 030 654 99 145 * fax 030 654 99 146 * email support@cytosorbents.com

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Topics: instructions for use dated 25.3.2011

o 1. CytoSorb Main points (Fig. 1) P. 2

o 2. INSTALLING CytoSorb INTO A RRT- SYSTEM FOR USAGE POST - DIALYZER P. 2-4

• Rinsing the Adsorber via gravity (Fig. 2 and 3) P. 2-3

• Installing CytoSorb into a newly set up device (Fig. 4) P. 4

• Installing CytoSorb into a running RRT-system P. 4

• Replacing CytoSorb during Adsorber-treatment P. 4

CytoSorb TRAINING Vers. 14.4.2014 post-Filter EN - Eva Page 1

 1. CytoSorb Main points (Fig. 1)

• The arterial tubing system should be pre-filled with priming solution before connecting the Adsorber.

No air must enter the Adsorber under any circumstances.

Fig. 1

• Anticoagulation needs to occur before treatment. aPTT target time is 60 - 80 seconds, ACT > 180% of
standard value. aPTT or ACT should be checked during therapy to ensure proper anticoagulation.

• Effectiveness of the removal of molecules is dependent on the blood flow rate through the Adsorber. The
blood flow rate should be between 200ml/min and 400ml/min. Lower blood flow rates may be compensated
for by extending the treatment time. The maximum running time of the Adsorber should not exceed 24 h.

2. INSTALLING CytoSorb INTO A RRT- SYSTEM FOR USAGE POST - DIALYZER

• Rinsing the Adsorber via gravity (Fig. 2 and 3)

• Materials:

• CytoSorb
• 2 Liters of isotone saline (priming-) solution (with Luer-Lock-connection)
• CytoSorb Priming Adapter 2
• CytoSorb Adapter 2
• Adsorber-holder
• tubing-clamps
• IV pole

• Procedure (figures 7 and 8)

1. Connect the intake tube (red) to the saline-bag

2. De-aerate
3. Clamp and connect, free from air, with adsorber’s blood inlet (observe direction of flow)
4. Attach connection tube (DIN-Lock blue female - Luer-Lock blue female) with connection tube (CytoSorb Pri-
ming Adapter 2/Luer-Lock blue male - Luer-Lock blue male) inclusive waste bag to blood outlet
5. Remove clamp
6. Rinse via gravity with 2 Liters of priming solution
7. De-aerate the Adsorber via repeated tapping
8. Clamp tubes on the Adsorber

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2. INSTALLING CytoSorb INTO A RRT- SYSTEM FOR USAGE POST - DIALYZER

Fig. 2

Priming with CytoSorb

CytoSorb
Priming adapter 2
adapter 2

Saline

CytoSorb Prim-
ing adapter2
CytoSorb

Waste

Fig. 3

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2.INSTALLING CytoSorb INTO A RRT- SYSTEM FOR USAGE POST - DIALYZER

• Installing CytoSorb into a newly set up device (Fig. 9)

1. Set up device according to the manufacturer’s instruction.

2. De-aerate Adsorber as described on page 5 (Rinsing of CytoSorb via gravity)
3. Device: stop the blood pump
4. Clamp the dialyzer at blood outlet and on dialysis side if applicable
5. Disconnect Luer-Lock connection between return line at dialyzer´s blood outlet and bubble trap
6. Connect dialyzer´s venous line (using Adapter 2) with adsorber´s blood inlet
7. Connect Adsorber with bubble trap by using CytoSorb Adapter 2
8. Turn Adsorber into upright position (observe direction of flow)
9. Release all clamps
10.Begin treatment

Fig. 4

Connections with CytoSorb Adapter 2

dializer/hemofilter

Return line

bubble trap
CytoSorb
Dialyzer

CytoSorb
Adapter 2

Arterial line

• Installing CytoSorb into a running RRT-system

1. De-aerate Adsorber as described on page 5 (Rinsing of CytoSorb via gravity)

2. Blood return and patient disconnection should be performed according to manufacturer’s instructions
3. Installation of the Adsorber as described on page 6 installing CytoSorb into  a  newly  installed  device)
4. Continue treatment

• Replacing CytoSorb during Adsorber-treatment

1. De-aerate Adsorber via gravity as described on page 5 (Rinsing of CytoSorb by gravity)

2. Blood return and patient disconnection should be performed according to manufacturer’s instructions
3. Device: stop the blood pump
4. Clamp the connection tube between the dialyzer and the Adsorber, as well as between the Adsorber and the
bubble trap
5. Disconnect the dialyzer from the Adsorber
6. Connect the new Adsorber to the dialyzer (use the new adsorber’s sealing cap to close off the used ad-
sorber’s blood inlet)
7. Remove the return line from the used Adsorber and connect it to the new Adsorber
8. Turn Adsorber into upright position (observe direction of flow)
9. Remove all clamps
10.Continue treatment

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