Alarmas InmediataUrgente NormalDetección de aire (detección de burbujas) X

Fuga de sangre X Presión venosa X Nivel del suministro de agua X Temperatura X

Conductividad X Presión arterial X Volumen de UF (Ultrafiltración) X Flujo de Sangre
X Tasa de Ultrafiltración X Final de infusión de heparina X

The same as for the TMP window, thephase volume is monitored with relativeand absolute limits that adjust
themselvesautomatically. If the lower relative phasevolume is undercut, an alarm is triggeredwith older software versions. If
this war-ning occurs frequently, change the bloodflow for a short time. This renews the set-ting of the limit window. The
warning Lower relative phase volumetoo lowis obsolete as from software ver-sions ≥8.20 For all other exceeding of limits, an
alarmis triggered. In case of phase volume alarms alwayscheck the system for air inflow, confirmonly after checking.
Optionally correctblood flow.Phase volumeWarnings and alarmsOptimum control pressures:Arterial mmHg Venous mmHgCentral
catheter / bis -200360 bis 390good fistulaFragile fistulabis -150300Initial punctures-120 bis -150250 bis 300By setting control pressures that are farapart, a
larger phase volume is achieved,closer limits result in a smaller phase volume. ■■■■TerminationLeave the 2nd pump
segment in thevenous blood pump.Activate the Reinfusioniconto extend the alarm limits.Check the height of the venous
bloodlevel and adapt as required.■■■Terminate the therapy in the usual way.
Brief Instructions – HDF/HF Online TherapyThe blood pump continues to run
until thevenous red sensor detects saline solutionor the blood pump is stopped. The administered reinfusion volume is
shown.Empty the bicarbonate cartridge and thedialyzer only when the patient has beendisconnected from the machine.Save
the dialysis data and start disinfection.Start of disinfection after therapy end or after filter change by touching
theDisinfectionicon and selection of the disinfecion mode.To continue see chapter disinfection.■■■Disinfection/Online
filter changeBy touching theFoldericon, the symbolfor the Online filter changeand theFilter drainingicon empty and
replacethe filter. A filter change must always befollowed by a disinfection.Doppelnadel-TherapieDoppelnadel-
TherapieKurzanleitung_Dia_gb.qxd 12.08.2008 7:26 Uhr Seite 12
The connection of the PBS pressuretransducer should always be performedbefore the blood-side self-test. If thesetting of
SN-CO should be requiredafter begin of treatment, confirm the PBS values shown then.It is also possible to select SN-CO

Brief Instructions – Single-Needle Cross-Over

beforeconnecting the patient.

Therapy (SN-CO)Single-Needle Cross-Over TherapyDoppelnadel-TherapieDoppelnadel-

TherapieConnect the PBS pressure sensor and theother pressure sensors.Adjust the liquid level in the arterial andvenous
chambers according to the drawing.Touch the Parametericon as well as theSNicon.Route the lines leading to the
patientthrough the respective clamps.SelectSN-CO.The preset limit values for the arterial and venous control pressure are
set automatically.Change to therapy mode by touching theConnect patienticon. Confirm thepatient data!Insert the 2nd pump
segment into thevenous pump. Start the blood pump, fill the system withblood and then connect the venous line to the
patient.Set-upMachine settingConnecting the patientFilling■■■■■■■Insert arterial and venous line
system:Do not yet insert the line segment of the2nd (venous) blood pump. Make sure thatthe 2nd pump segment is
abovethepump.Start the blood pump with 100 – 120 ml/minwhen connected to a fistula.Recommendations for
blood pump rate and phase volume■Level in arterial expansion chamberLevel in venous expansion chamberPVPAWhen connected to
a central venouscatheter, start with 150 ml/min.■Kurzanleitung_Dia_gb.qxd 14.08.2008 13:57 Uhr Seite 13

Brief Instructions – Single-Needle Cross-Over Therapy (SN-

CO)Target value for phase volume, approx. 30 – 35 ml Check of the phase volumes, blood flowand pressure values via
theSNiconRecommended control pressuresIf the phase volume is too small, slowlydecrease the blood pump speed in
smallsteps.The phase volume reacts to:- Change of blood flow- Change of control pressures- Height of blood level in the
chambers- Pressure changes in the shunt- Stop of blood pump when alarms occurDuring dialysis, monitor the fluid in
bothchambers (if required, regulate fluid level)and the size of the phase volume (if necessary, correct blood flow).The same
as for the TMP window, thephase volume is monitored with relativeand absolute limits that adjust themselvesautomatically. If
the lower relative phasevolume is undercut, an alarm is triggeredwith older software versions. If this war-ning occurs
frequently, change the bloodflow for a short time. This renews the set-ting of the limit window. The warning Lower relative
phase volumetoo lowis obsolete as from software ver-sions ≥8.20 For all other exceeding of limits, an alarmis triggered. In
case of phase volume alarms alwayscheck the system for air inflow, confirmonly after checking. Optionally correctblood
flow.Phase volumeWarnings and alarmsOptimum control pressures:Arterial mmHg Venous mmHgCentral catheter / bis -200360 bis 390good
fistulaFragile fistulabis -150300Initial punctures-120 bis -150250 bis 300By setting control pressures that are farapart, a larger phase volume is
achieved,closer limits result in a smaller phase volume. ■■■■TerminationLeave the 2nd pump segment in thevenous
blood pump.Activate the Reinfusioniconto extend the alarm limits.Check the height of the venous bloodlevel and adapt as
required.■■■Terminate the therapy in the usual way.■Doppelnadel-TherapieDoppelnadel-TherapieKurzanleitung_Dia_gb.qxd
13.08.2008 7:47 Uhr Seite 14

Brief Instructions – Single-

The SN valve mode can also be activatedduring treatment.

Needle Valve Therapy (SN-V)Single-NeedleValve Therapy Insert the arterial standard line;
lead thearterial line through the arterial clamp(SAKA). Use a special venous line for the SN valvewith 100 ml pressure
compensationchamber, as this enables a higher phasevolume and thus a clearly increased efficiency of treatment. If the SN
valvedialysis is not planned, the standard linecan remain in place. For efficiency improvement, the venous level must be
reduced here before the beginning of the SN valve therapy.Fill the liquid level in the venous chamberonly up to approx. 40%
so that an adequate phase volume can be achieved. Touch the Parametericon as well as theSNicon.Select SN valve.Start
the blood pump depending on thevein condition and increase slowly. Setup and fillingMachine setting■■■■The
preset limit values for the arterial andvenous control pressure are entered auto-matically.Connecting the
patientPhase volumeChange to therapy mode by touching theConnect patienticon. Confirm patientdata!Connect the
arterial line and fill thesystem with blood; the SN valve mode has already been automatically activated. ■■By setting control
pressures that are farapart, a larger phase volume is achieved,closer limits result in a smaller
phasevolume.Kurzanleitung_Dia_gb.qxd 12.08.2008 7:26 Uhr Seite 15

Brief Instructions – Single-Needle Valve Therapy (SN-

V)Recommendations for phase volumesWith small venous air trap (30 ml): 12 – 18 mlWith large venous pressure
compensationchamber (100 ml): 15 - 25 mlThe phase volume reacts to:- Change of blood flow and control pressures- Height
of blood level in venous chamber- Pressure changes in the shuntIn addition, the phase volume can be optimized by adapting
the BP speed. If thedifference between the control pressuresis smaller, the phase volume becomessmaller, however,
switching to the arterialphase is achieved quicker and the mediumblood flow thus increased.The SN valve has a combined
pressure andpressure/time control. The optimum andadapted return time is set automatically.It is possible that the lower
arterial limitvalue (min PA) has to be adapted.Setting of control pressures: - min PV 120 - 150 mmHg - max PV 350 mmHg
After selection of the Terminate therapyicon the Reinfusion window is openedautomatically if preset accordingly. Otherwise,
it must be manually selectedso that reinfusion starts in double-needlemode. The pressure limit value windows expandand
the reinfusion volume is displayed.Before start of the reinfusion, alwayscheck the height of the venous blood leveland
increase the blood level, if required.Disconnect the patient as usual.■■■■■■■Control and
monitoringTerminationKurzanleitung_Dia_gb.qxd 12.08.2008 7:26 Uhr Seite 16

Overview of IconsOverview IconsIcons are control buttons on the touch screen used for operating the
dialysis machine.Depending on the displayed window, different icons are available, which all represent a specific action. By
touching an icon, the respective action is carried out. A list of the most important icons is provided below.Leave window and
accept dataLeave window without accepting dataCall up help function for explaining theiconsCall up history of current
disinfectionCall up service screenSwitch off all icon functions for 10 sec to allow cleaning of monitorSet brightness of
monitorLeave current windowCall up overviewCall up respective parameter windowSet treatment parametersReturn to
program selectionCreate (format) floppy disk/therapy cardRead patient data from disk/therapy cardSave patient data to
disk/therapy card Select further setting optionsReduce valueIncrease valueKurzanleitung_Dia_gb.qxd 12.08.2008 7:26 Uhr
Seite 17