Pg (1 of 7)
The priming procedure will be required on either
initial prescription of RRT or as a result of filter/circuit
clotting on a patient already receiving therapy.
Prior to setup, prescription for the treatment by
medical staff should be obtained. Type of therapy
(CVVH, CVVHDF etc), UF rate, fluid loss, fluid
composition (bicarbonate, lactate etc) and
Priming can be performed at the bedside or away
from the clinical area. The HF 440 has a ‘shutdown’
option post priming so the machine can be
transferred to the bedside.
Plug in machine power cable to UPS power supply
Press on/off button (O/I) to power up machine
Machine will perform self-test
Wait until screen displays ‘treatments available’ –
Select treatment (CVVH, CVVHDF, TPE, CPFA etc)
Lines required (hemofiltration, hemodiafiltration,
hemofiltration) and Filter required (hemofiltration,
High Flux dialyser, Plasmafilter) will be displayed.
Rinsing or priming volume will also be indicated
Machine will perform another quick self-test
Pg (2 of 7)
* model displayed has CPFA option
Place hemofilter/dialyser in holder on side of the
Open kit (HF, HDF) on a clean flat surface
All lines (arterial, venous, replacement, dialysate,
ultrafiltrate) are attached to a plastic backing plate
Identify cut-outs for roller pumps in the plastic
Attach backing plate and circuit over roller pumps
Identify roller pump segments on the circuit for
blood pump, waste pump, predilution/dialysate
pump and replacement pump
Open pump doors (lift up latch)
Load the 4 plastic pump segments making sure
segment fits across middle of rollers
Close pump doors (pull down latch) – this will now
hold plastic backing plate and circuit to the
Pg (3 of 7)
ON SCREEN display has 4 screen tabs (venous,
purification, arterial and heater)
Venous – connect venous pressure sensor (V),
insert line into air detect sensor and clamp.
Connect venous line to filter. Make sure
connections are tight, not cross threaded.
Purification – Attach ultrafiltrate connecter to
haemofilter, connect UF pressure sensor. Insert
blood leak detector chamber into sensor and
connect UF line to waste bottle / bag. In CVVH
mode ensure unused luer lock port on haemofilter
Arterial – Connect arterial end to haemofilter.
Ensure all connections are tight.
Connect prefilter (P) and arterial (A) pressure
Push line onto sensor before tightening clockwise
Pg (4 of 7)
Attach fluids line to multiflow extension and connect
to replacement/dialysate bags x 2.
Normal saline (2 x 1 litre bags) are recommended
by the membrane manufacturers as the priming
Heater bag comes as a separate item. Place bag
against heater plate gently, as described below.
Make sure there are no creases or kinks in bag or
Fit top of heater bag to 3 locating pins on the heater
plate and 2 bottom locating pins on the bottom of
the heater plate.
pg (5 of 7)
The main fluid pathway between the main fluid roller
pump (bottom right – blue) and the replacement
/dialysate roller pump (top right – blue) has a luer
connection for connection to heater bag if used
Open this luer connection
The upper end closer to the bifurcation to the venous
chamber and the predilution/dialysate pump can now
be attached to the top of the heater bag
The lower end, closer to the main fluids pump, can
now be attached to the bottom connection of the
Pg (6 of 7)
Once the circuit is fully attached, ensure all clamps
are open and connections are tight.
In addition, ensure priming solution bag tabs are
broken to allow free flow of fluid into the circuit
Press “start” to begin the priming procedure
Priming is semi automated, when circuit and
haemofilter are filled with priming solution (approx. 8
mins), you will be prompted to adjust the level in the
venous bubble chamber.
Follow on-screen instructions and press validate (√ )
Priming will then continue for a further 2 mins
Once priming is complete, the following screen will
There are 5 options
“Shutdown” – if the machine requires movement to
the clinical area or repositioning, this option may be
selected. Selecting shutdown will prompt the user to
turn off the machine using the on/off button on the
rear of the machine (I/O). Do not turn off the
machine by turning off mains power or removing AC
cord. When machine is in the correct position for
treatment and re-attached to UPS power, the
machine may be turned on again. After initial selftest the machine will display this screen again for
pg (7 of 7)
“Additional rinsing” – Selecting this option will initiate
further rinsing of the circuit and haemofilter. This
option may be required to remove any residual air
bubbles in the circuit.
“Treatment” – Selecting treatment will instigate the
treatment screen. Blood flow, UF, Dialysate and
circuit pressures can now be set prior to attachment
to vascular access.
“Bubble trap” – Selecting this option allows the readjustment of the fluid level in the venous chamber.
“Change container” – allows adjustment of the scale
settings (weight) for both ‘waste full’ and ‘substitution
* Another way to adjust the blood/fluid level in the
venous chamber is to attach a syringe via a 3-way
tap to the chamber so that alteration can be made
during the course of the treatment without
interruption to blood flow or treatment.
Connect a 3-way tap to the top of the venous
chamber port with clamp
Attach 20mL syringe to one port of the 3-way tap
Attach male/female dead end cap to other port of
3-way tap and reconnect to priming line (this line
joins to blood leak detector and is only used during
priming phase.) Dead end cap prevents any blood
from the venous chamber entering the blood leak
detector (see picture).