We are having an issue with our intrauterine wash procedure and the Cobe 2991.  When we wash a unit for an IUT, we end up with at least 200mL of saline left over in the bag.  We are using the same process for washing RBC units but have added a final 5 minute spin to pack the RBC in the IUT.  Are settings are listed below.  Has anyone had this problem or can shed some light on what we may be missing?  Any help is appreciated.

It doesn't sound like the Spin Cycle in the process is the problem if it still manages to run for 5 minutes. It seems like the problem would be the Agitate/Wash-In if the entirety of the solution isn't entering the bowl?

I noticed the saline won't fully enter the bag during cycles if the tubing itself is kinked, but that's more of a physical problem. 

Slightly off topic, but we don`t wash our units for IUT. What anticoagulant for the blood collection do you use? We use blood collected in CPD with no SAG-M added, which normally has an HCT of around 80%. So no washing is required.

Same here.

We don't do IUT (we get them after they're born) but we wash red cells all the time.  Our red cell override is set at 3 minutes but all other settings match ours.  When's the last time the unit was primed and the RCD cleaned?  Maybe there's a bubble in the line to the hydraulic fluid.  You could also add a manual spin followed by super out after the program ends to ensure a majority the saline is removed.  That's what we have as troubleshooting if the excess pressure light comes on or the lid will not open because the bag is overfull.  

We use the Cobe 2991 as well for IUT.

Your setting looks identical to our except we do not differentiate between Wash RBC and IUT Protocol.  It was suggested once, but the terumo engineer and our medical director deems it was not necessary. 

We just use your Program 0 setting for our IUT washing.  I think we also have about 100mL saline left over for Red cell washing.

The only one that empty the saline bag is washing platelet with it two pre-dilution.   

 

How much volume was in your RBC and was 200mL pre-dilution complete?  The donut also hold about a max volume of 600mL(I want to say it's more like 630 but I don't have the manual with me)

Did you observe your Red Cell detector?  Maybe it is stopping the superout too soon thus leaving more volume in the donut and the saline cannot complete fill for each cycle. Is waste line getting kink so it cannot superout?  Can't think of anything else that may cause the issue. 

 

 

 

It seems like a problem with the hydraulic fluid, not enough being pumped into the bowl.