Spectra Optia Apheresis System Operator’s Manual
159
Continuous Mononuclear Cell Collection (CMNC) Procedures
11
•
Decrease the collection preference. The interface may not be high enough to allow the system to collect the
buffy coat.
Collecting a Target Volume
If the procedure goal is a specific volume in the collection bag, consider changing the collect volume. This causes
the collect volume to become the run target. This target only includes the volume pumped by the collect pump.
The volume of any plasma collected is not included.
Decreasing the Run Time
Consider the following alternatives for decreasing the predicted run time if a shorter run is necessary:
•
Avoid pausing the pumps and conditions that cause the pumps to pause, such as alarm conditions. After the
pumps restart, it takes time for the pumps to reach the target flow rates again, which adds time to the run.
•
Increase the inlet pump flow rate or increase the AC infusion rate. Increasing these rates allows the system to
process more blood in less time. Be aware that either option results in a greater volume of AC delivered to the
patient and increases the potential for the patient to experience a citrate reaction.
•
Increase the inlet:AC ratio. This causes the inlet pump flow rate to increase. However, it decreases the system’s
ability to manage anticoagulation of the extracorporeal circuit and can result in clumping in the circuit.
Monitor the run carefully as you increase the inlet:AC ratio.
•
Decrease the target run time. Make the run time the run target by entering the desired time on the run values
or run targets screen. This ensures that the run ends when required.
If you decrease the run time and intend to collect plasma at the end of the run, make sure you review the
target plasma volume on the run values screen and confirm that it is still appropriate. The system prioritizes
collection of the target collect volume over the target plasma volume. This means that if you decrease the run
time, the system will decrease the target plasma volume. You can increase the target plasma volume if it is too
low, but be aware that the collect volume will decrease as a result.
Addressing Clumping in the Connector
Clumping can affect collection efficiency by interfering with the separation in the connector. The potential for
platelet clumping is difficult to predict since it does not always correlate with the patient’s platelet count. If you see
platelet clumping in the connector, perform the following steps:
1
Decrease the inlet:AC ratio to 8:1 until the clump disappears and until the system has processed at least
100 mL of inlet volume.
2
Check the connector for clumping and then perform one of the following steps:
• If the clumping is resolved, consider increasing the inlet:AC ratio to 10:1. Allow the system to process
500 mL to 1,000 mL of inlet volume before you consider increasing the ratio again. Do not increase the
ratio by more than 2.0 for every 500 mL to 1,000 mL of inlet volume processed.
• If the clumping persists, leave the inlet:AC ratio at 8:1 until the clumping disappears or for the remainder
of the run. Some clumps may become clots that are difficult to eliminate. Maintaining the ratio at 8:1 will
help minimize the impact on the collection efficiency.
For additional information about anticoagulation in the tubing set, see “Managing Anticoagulation of the
Extracorporeal Circuit” on page 221.
SpectraOptiaOpsManual.book Page 159 Thursday, May 17, 2018 11:24 AM
