Instructions for use: Ikus - Berlin Heart

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Guidelines for anticoagulation therapy Medication - start if... Dosage guidelines Laboratory and target values UFH • > 24 h post op • Platelet count (>50 k/µl) • Coagulation status normal (TEG) Vitamin K antagonist Complete oral nutrition possible Inhibition of platelet aggregation Start with 5 - 7 IU/kg/h (no bolus) • depending on liver function • At INR > 5: pause Check aPPT every 6 h Platelet count POD 1, platelet count normal as of POD 2: < 40 k/µl as of POD 2: 50 - 100 k/µl as of POD 2: > 100 k/µl Target aPTT 50 - 60 s normal 22/28 1000095x14 Rev. 8 INR 50 -60 s 1.5 - 2.0 60 -80 s 2.0 - 2.5 • Check INR daily • Target INR 3.0 - 3.5 • With low INR see LMWH guidelines (see below) Collagen serves as control and should not be suppressed. Target value epinephrine: 40 – 50% Dipyridamole: POD 2 and ADP > 50% Aspirin: POD 4, if all drains and AA > 50% Clopidogrel: in the event of resistance to aspirin or thrombo-embolic complications Start with 150 mg/d (up to 1 g/d) Start with 50 mg/d (increase as required) ADP < 50% AA < 30% Start with 75 mg/d ADP < 30% Tab. 2 Guidelines for anticoagulation therapy in young persons and adults
Medication - start if... Dosage guidelines Laboratory and target values Fractionated heparin (LMWH) Start at suboptimum INR or if • oral administration not possible • INR unstable • changing antibiotics Omega 3 fatty acids EPA/ DHA 1 - 3 g/d Dosage (e.g. enoxaparin): every 12 h • INR = 2.0 - 2.5: prophylactic dosage (1.0 mg/kg/d) • INR < 2.0 (or use of i.v. UFH): therapeutic dosage (1.0 mg/kg, 2x/d) Tab. 2 Guidelines for anticoagulation therapy in young persons and adults Target: anti-Xa level Therapeutic level 0.6 - 1.0 U/ml divided over 2 doses per day • blood withdrawal 4 h after 2nd dose • at stable level: check once weekly 1000095x14 Rev. 8 23/28
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EXCOR ® VAD with Stationary Drivin
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ii 1000002 Rev. 4.9.1
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4.6.4 Battery mode.................
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9.1.1 Example: Anticoagulation ther
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13.3.2 Ikus: connection panel .....
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INDEX Driving units 88 DT, Destinat
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INDEX System has reached maximum ca
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2 1000002 Rev. 4.9.1
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Risks and adverse effects Important
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Operator obligations General produc
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Disposal General product informatio
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EXCOR cannulas Description: Blood p
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EXCOR accessories Description: Bloo
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Displays and operating elements Des
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Operating modes Description: Statio
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Safety Description: Stationary Driv
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Start menu Instructions for use: Ik
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Fundamentals of the monitoring prog
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Stop the blood pumps, switch off th
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Switching between mains power and b
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Routine start test in the event of
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Packaging and transport Instruction
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Preparations outside of the operati
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Intraoperative drive management Sta
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Postoperative drive management Star
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Pump with PU valve Implantation: Pr
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De-air the pump Implantation: Prepa
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Apex cannula(s) Implantation - Surg
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Outflow cannula(s) Implantation - S
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Connect the pumps to the cannulas I
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After the operation Implantation -
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Postoperative anticoagulation thera
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Antibiotic therapy Intensive care a
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Regular inspection of blood pump(s)
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Regular inspection of blood pump(s)
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Weaning (Bridge-to-Recovery, BTR) E
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Batteries discharged; battery mode
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Do not operate the driving unit wit
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FATAL: Battery failure! Inform Serv
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No internal communication Error mes
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System 3 is faulty Error messages a
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Error messages during the start tes
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Replace the blood pump(s) Detecting
Page 92 and 93: Restart the Ikus Detecting and elim
Page 94 and 95: Connect the patient to the replacem
Page 96 and 97: Failure of the power supply or both
Page 98 and 99: Battery fuse Detecting and eliminat
Page 100 and 101: Overview: Product range and combina
Page 102 and 103: Overview: Product range and combina
Page 104 and 105: Symbols Appendix Diastolic pressure
Page 106 and 107: EXCOR standard forms implantation r
Page 108 and 109: Standard form: EXCOR pump log Appen
Page 110 and 111: Standard form: EXCOR emergency log
Page 112 and 113: Standard form: Blood pump replaceme
Page 114 and 115: Additional information: Laptop Pana
Page 116 and 117: Electromagnetic immunity - Part 1 E
Page 118 and 119: Recommended protection distances EM
Page 120 and 121: Explanations About these instructio
Page 122 and 123: Table of contents First page.......
Page 124 and 125: Safety information 1 Important safe
Page 126 and 127: Warranty 2.5 Manufacturer's warrant
Page 128 and 129: � New transport crate 5.8 Packagi
Page 130 and 131: 8. Check that the manual pump is fi
Page 132 and 133: 17. Secure the latches with cable t
Page 134 and 135: Fig. 11 Recommended cannula exit si
Page 136 and 137: WARNING When using a connecting set
Page 138 and 139: Securing the connections 8.8 Securi
Page 140 and 141: If necessary: correct the settings
Page 144 and 145: Replacing the driveline 11.5.1 Repl
Page 146 and 147: Emergency pulse mode Changes: • T
Page 148: Discontinuation of the mandrin 13.1
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Instructions for use: Ikus - Berlin Heart

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