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Processing
X
TRA
Operator’s Manual
20077/021 US
5-23
The Autotransfusion Protocols
The intraoperative (Popt, Pstd and Pfat) protocols will concentrate, wash, and collect the blood lost by
the patient during a surgical intervention. The postoperative protocol (Post-op) will do the same for
blood drained from a surgical cavity of a patient after a surgical intervention.
Note: The Post-op protocol is similar to the Popt protocol. The only difference is that in the Post-op
protocol the X
VAC
vacuum pump is set to its postoperative functioning mode, while in the Popt protocol
it is set to its intraoperative mode.
All ATS protocols (except for Pfat) are carried out through the execution of three phases in this
sequence:
1. Fill Phase
2. Wash Phase
3. Empty Phase
First, blood is taken up from the operating field, extra-corporeal circulation circuit, or surgical cavity
and treated with anticoagulant. It is then sent into the collection reservoir where it is filtered and
stored. Next, during the Fill phase, the system transfers blood from the reservoir into the spinning
centrifuge bowl by use of the peristaltic pump. Centrifugation concentrates the red blood cells into the
bowl while supernatant components are expelled to a waste bag. Next, during the Wash phase, a
volume of saline solution is washed through the concentrated red blood cells to remove the free
plasma hemoglobin, anticoagulant, and other waste components. Finally, during the Empty phase, the
concentrated red blood cells, with minimized amounts of waste contaminants, are pumped into the
RBC bag to be returned to the patient as directed by the responsible medical practitioner. The Pfat
protocol differs from the other ATS protocols by an additional phase performed between the Wash and
Empty phases, named the Fat Removal phase. During this phase the RBCs are washed at a higher flow
rate and re-concentrated to optimize the removal of fat particles.
While processing with the ATS protocols, the X
TRA
machine is set up with three lines connected to the
bowl inlet:
• One connected to the reservoir (fill line),
• One connected to a bag containing the washing saline solution (wash line), and
• One connected to the RBC collection bag (empty line).
The outlet line of the bowl is connected to a waste bag (see Figure 5-27).
Figure 5-27 Disposable Setup for ATS Protocols