Department of Nephrology and Blood Purification, Saitama Medical Center, Saitama Medical University, Japan.
ASAIO J. 2012 Mar-Apr;58(2):127-31. doi: 10.1097/MAT.0b013e318241f506.
Most dialysis clinics in Japan have mainly adopted the central dialysis fluid delivery system (CDDS) to provide constant treatment to many patients. Chemical disinfection is the major maintenance method of the CDDS. Our clinic introduced an automated hot water disinfection system that used the heat conduction effect to disinfect a reverse osmosis (RO) device and dialysis fluid supply equipment. Endotoxin level and the amount of viable bacteria often showed abnormal values before introduction of this system. After its introduction, weekly disinfection resulted in endotoxin levels and the amount of viable bacteria lower than measurement sensitivity. In hot water disinfection, water heated to 90°C in the RO tank flows into the dialysis fluid supply equipment. The maximum temperature inside the tank of the supply equipment is 86.3°C. (We confirmed that the temperature was maintained at 80°C or more for 10 minutes or more during the monitoring.) Dialysate purification was maintained even after introduction of the automated hot water disinfection system and the dialysate could be supplied stably by the CDDS. Therefore, this disinfection system might be very useful in terms of both cost and safety, and can be used for dialysis treatment of multiple patients.
日本大多数透析中心主要采用中央透析液输送系统 (CDDS) 为许多患者提供持续治疗。化学消毒是 CDDS 的主要维护方法。我们的诊所引入了一种自动化热水消毒系统，该系统利用热传导效应对反渗透 (RO) 装置和透析液供应设备进行消毒。在引入该系统之前，内毒素水平和活菌数量经常出现异常值。引入该系统后，每周的消毒可使内毒素水平和活菌数量低于测量灵敏度。在热水消毒中，RO 罐中加热至 90°C 的水流入透析液供应设备。供应设备罐内的最高温度为 86.3°C。（我们在监测过程中确认，温度在 80°C 以上保持 10 分钟或更长时间。）即使引入了自动化热水消毒系统，透析液净化仍能得到维持，并且 CDDS 可以稳定地供应透析液。因此，从成本和安全性两方面考虑，这种消毒系统非常有用，可用于多位患者的透析治疗。
