Table 2
Traditional oxygenator changeout procedure requiring temporary interruption of extracorporeal support. These steps occur after multidisciplinary discussion that determines the PaO2 change-out threshold, the patient temperature for the procedure, and timing. The perfusion team communicates progress to the care team during the procedure.
| Oxygenator change-out procedure |
| 1. Prepare sterile cut locations: scissors, betadine/alcohol, towels, and flush solution for connections. |
| 2. Primary perfusionist to decide if oxygenator-only change-out will be performed versus an oxygenator-reservoir change-out. |
| 3. Confirm sufficient venous reservoir volume for procedure. |
| 4. Come off bypass and clamp arterial and venous lines (drain patient vs. fill up per status of native cardiopulmonary function). |
| 5. Replace oxygenator (± reservoir) with new clear-primed device using precut/clamped segments of tubing with connectors already attached. Use flush solution for connections as needed. |
| 6. Move sweep gas line to new oxygenator. |
| 7. Flow through recirculation limb and verify circuit is deaired. |
| 8. Perform re-establishing bypass checklist. |
| 9. Initiate CPB. |
| 10. Perform secondary checklist once back on CPB. |
| Reestablishing bypass checklist |
| 1. Tubing connections correct and tight. |
| 2. Circuit deaired. |
| 3. Sweep gas on and line reconnected. |
| 4. Tubing clamps off boot. |
| 5. Extra clamp(s) removed from arterial line. |
| 6. Recirculation line and purge line clamped. |
| 7. Pressure dome and manifold line reconnected and opened. |
| 8. Communicate circuit status with surgeon. |
| Secondary back-on checklist |
| 1. Verify blood color and Terumo CDI values. |
| 2. Change over water lines. |
| 3. Reconnect temperature probe(s). |
| 4. Tie band connections. |
| 5. Connect WAGD line. |
*WAGD = waste anesthesia gas disposal.
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