During a therapeutic plasma exchange (TPE) procedure on Spectra Optia, the Automated Interface Management (AIM) System may display the algorithm control icon, which indicates the AIM system is unable to identify a stable interface.
The most common cause for the icon to appear is turbulence.1 Turbulence can be related to a number of factors — from the pump flow rate to certain patient conditions. Here’s how to troubleshoot the situation.
When the algorithm control icon is displayed, the system is using a calculation to manage the interface position. The plasma pump flow rate is based on the entered patient hematocrit (Hct). Algorithm control results in decreased plasma removal efficiency, and procedure time may increase.
Turbulence may be caused by:
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High inlet pump flow rate
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Low packing factor
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Platelet swirling
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Certain patient conditions, such as hyperviscosity (which causes the poor separation of the blood) or mild lipemia (which looks like platelet swirling to the AIM system)
Your first step is to look through the view port to observe and assess the plasma separation in the connector. If the plasma appears turbulent, follow the troubleshooting steps below.
Troubleshooting options are:
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Decrease the inlet pump flow rate to increase the packing factor. This will decrease turbulence in the connector. An inlet pump flow rate of 62 mL per minute will result in a packing factor of 20. A packing factor of 20 may allow for optimal separation of cells and may decrease turbulence in the connector.
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If there is no turbulence, you can wait, and let Spectra Optia attempt to see the interface clearly.
Source:
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Terumo Blood and Cell Technologies. Therapeutic plasma exchange (TPE) procedure training (including single needle option). 2022. Part number TS-OPTI-01505.