Fresenius Medical Care 5008, Operating Instructions Manual

Page: 239 / 328

Chapter 11: System Description
Fresenius Medical Care 5008 OP 5/09.06 11-29
The ONLINE plus ™ option consists primarily of a substituate pump, the
substituate port (to connect the SafeLine™ disposable as substituate
line), a rinse port (to rinse the dialyzer) and two DIASAFE
®
plus filters.
Apart from the preparation of the substituate from the dialysate, the
ONLINE
plus ™ also provides the following functions:
– Priming/rinsing the extracorporeal blood circuit with substituate
– Infinite rinsing of the EBC and the dialyzer
– Bolus with substituate; a bolus can also be given in HD, provided the
SafeLine™ is connected (the bolus will NOT be balanced!)
– Reinfusion (blood return) with substituate
O
Intended use
Fields of application In addition to hemodialysis (HD) the ONLINE plus ™ option also
supports the following procedures (the treatment mode can be changed
during the treatment):
– Hemofiltration (HF) pre-/postdilution
– Hemodiafiltration (HDF) pre-/postdilution
– ONLINE priming and rinsing of the extracorporeal blood circuit
– Bolus administration in case of hypotension
Chemical composition of
the substitution fluid
produced online The chemical composition of the fluid produced with the ONLINE plus ™
is identical to the composition of the fresh dialysate selected by the
operator. This applies to all electrolytes contained in the dialysate and
especially the bicarbonate content of the fluid.
The amount of bicarbonate to be considered is determined by:
Restrictions An HF treatment may not be performed with a dialyzer with one filtrate
connector (HF filter without dialysate couplings).
11.5.7 SN Description (Option)
During SN dialysis, blood is alternately collected from and returned to
the patient through one needle. (2-pump procedure).
When the arterial clamp is open the arterial blood pump rotates and
delivers blood into the SN chamber. The volume delivered depends on
the stroke volume set (10 to 50 ml). The Single-Needle pump is stopped
and the venous occlusion clamp is closed. The external compliance
chamber is connected to the Single-Needle pressure transducer. The
internal compliance chamber located within the EBM is filled with air.
The arterial blood pump stops and the arterial clamp closes as soon as
the stroke volume and pressure is achieved. The SN blood pump
rotates and pumps the blood through the dialyzer, the venous bubble
catcher and the venous occlusion clamp into the patient. As soon as the
pressure in the internal compliance chamber reduces below the lower
set limit, the process described above restarts.
Quantity
bicarbonate [mmol] = volume
infused [l] X bicarbonate concentration of
the dialysate [mmol/l]