Page 37 - ANZCP Gazette May 2023

PERFORMER 3 – HYPERTHERMIC INTRAPERITONEAL PERFUSION REM Systems, Australia & New Zealand
The Performer 3 equipment is an electromechanical device for the extracorporeal circulation of liquids, used in Hyperthermic Perfusion therapies, in particular for the therapy of Hyperthermic Intra-Peritoneal Chemotherapy (HIPEC), to provide localized hyperthermia through the circulation of hot solutions, enriched with chemotherapy drugs, in the peritoneal cavity for a time that can be set between 30 and 120 minutes. The treatment can be performed in the conditions of open abdomen or closed abdomen, after introducing and positioning the probes for monitoring the temperature and catheters for connecting the extracorporeal circulation circuit.
The Performer 3 equipment is provided with an extremely simple user interface that consists of a high-definition colour graphic display combined with a touchscreen, which allows, using graphic images and icons, the information to be displayed in an extremely clear way, making it easy and immediate to activate the various available functions for carrying out the treatment.
The activation of automatic procedures for restoring the treatment in case of problems and the presence of a Help- on-line system, allow the operator to manage anomalous situations quickly and effectively, in conditions of maximum safety and with minimum manual intervention.
A dedicated pre-assembled disposable circuit, which allows the operator to prepare the device in a few minutes and to minimise the possibility of incorrect assembly of the lines, thanks also to the on-screen set-up instructions.
The temperature of the liquid entering the patient is controlled through a double plate heater, located on the left side of the device, which transfers the thermal energy to the liquid through a plastic bag, integrated into the disposable circuit, which acts as a heat exchanger.
The maximum settable temperature (measured at the heater outlet) is 45°C.
The temperature control is carried out through two temperature sensors: one inserted in the tube at the outlet of the heater and one, optical, at the inlet.
Patient temperature monitoring takes place through the use of up to 9 disposable thermistor temperature probes connected directly to the equipment through the HUB module, which can be positioned on both sides of the equipment at the operator's discretion and in relation to the position of this in the operating room.
The temperatures are shown on the display both in graphic form, for immediate interpretation, and in numerical format; it is also possible to view the average temperatures throughout the procedure, leaving the choice of probes to be used to calculate the value to the operator.
Performer 3 integrates two peristaltic pumps that allow the solution to circulate with a maximum flow rate of 3 L/min.
The pumps are also equipped with an integrated lever that facilitates the insertion and removal of the pumping segments.
The flow rate is set via a dedicated control panel, located on the front of the equipment, which also features the pump stop/start button and a display for viewing the flow rate.
In the event of a control panel failure, the flow rate can be viewed and set via the display.
The volume of the solution in the patient's body cavity is controlled automatically by the equipment by acting on the speed of the return pump, to keep the volume present in the body cavity equal to the value set by the user (maximum 7 litres).
In the event of abnormal conditions that cause an excessive or insufficient volume in the patient, the system automatically activates a volume restoration procedure, to bring the patient volume back to the set value.
Performer 3 integrates four sensors for monitoring the delivery/withdrawal pressure to/from the patient, withdrawal from the reservoir, and heater inlet.
If the pressures exceed the safety threshold, the system activates the corresponding alarm.
In particular, in the event of a patient withdrawal pressure alarm, the device automatically stops the withdrawal pump and simultaneously activates the By-pass phase, which allows the circulation through the body cavity to be temporarily interrupted while keeping the circulation through the heater active, to maintain the temperature of the solution at the set value: in this way, the waiting time for temperature recovery is reset once the circulation through the body cavity is reactivated.
Performer 3 is equipped with a special Flow Diverter function that allows the system to send the hot fluid to the patient selectively in a single inlet line at a time, automatically switching every 5-30 seconds, to improve the circulation and the distribution of the temperature inside the patient's abdomen.
Performer 3 can activate acoustic and visual signals to draw the user's attention in situations where a safety device detects an abnormal condition or when the value of a parameter exceeds the defined limits.
Performer 3 has been designed in accordance with the safety requirements in force and includes a series of initial self- tests to verify the correct functionality of the devices before carrying out each treatment and self-tests at the beginning of the Preparation to check the correct positioning of the kit and sensors.
For further information please contact
Simone Tenge
Product Specialist Critical Care. CCRN. PGDipSci.
+61 2 9814 2000
+61 447 926 070 STenge@remsystems.com.au
www.remsystems.com.au
MAY 2023 | www.anzcp.org 34