Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA.
Gastrointest Endosc. 2019 Jan;89(1):124-132.e2. doi: 10.1016/j.gie.2018.08.033. Epub 2018 Aug 25.
Residual fluid within endoscope working channels after reprocessing may promote growth of pathogens. Current reprocessing guidelines therefore recommend endoscope drying with administration of forced filtered air; however, the duration and modality of administered air are not specified. The new DriScope Aid device enables automated administration of filtered air at controlled pressure through all internal endoscope channels. We systematically compared, for the first time, the impact of manual drying and automated drying on retained working channel fluid and bioburden after reprocessing.
We assessed for residual working channel fluid after reprocessing and/or drying by using the SteriCam borescope. Drying was performed either manually (forced filtered air) or was automated (DriScope Aid) for either 5 or 10 minutes. Adenosine triphosphate (ATP) bioluminescence testing was performed on working channel rinsates after drying, to evaluate for residual bioburden.
Significantly more fluid droplets were evident after manual drying (4.55 ± 6.14) than with automated device-facilitated drying for either 5 minutes (0.83 ± 1.29; P = .007) or 10 minutes (0 ± 0; P = .001). ATP bioluminescence values were higher for manual drying compared with automated drying at 48 hours (P = .001) and 72 hours (P = .014) after reprocessing.
We demonstrate significantly fewer water droplets and delayed ATP bioluminescence values within endoscope working channels after automated drying compared with manual drying. In particular, virtually no retained fluid was evident within endoscope working channels after automated drying for 10 minutes. These findings support recommendations for automation of as many reprocessing steps as possible. Automated drying may decrease the risk of transmission of infection related to endoscopy.
内镜工作通道内的残留液体在重新处理后可能会促进病原体的生长。因此，目前的重新处理指南建议使用强制过滤空气对内镜进行干燥；然而，管理空气的持续时间和方式没有具体说明。新的 DriScope Aid 设备可通过所有内部内镜通道自动管理受控压力下的过滤空气。我们首次系统地比较了手动干燥和自动干燥对重新处理后残留工作通道液体和生物负荷的影响。
我们使用 SteriCam 硬管镜评估重新处理和/或干燥后的残留工作通道液体。干燥方法为手动（强制过滤空气）或自动（DriScope Aid），持续时间分别为 5 分钟或 10 分钟。干燥后，通过工作通道冲洗物进行三磷酸腺苷（ATP）生物发光检测，以评估残留的生物负荷。
与手动干燥（4.55±6.14）相比，使用自动设备辅助干燥时，明显有更多的液滴可见，无论是 5 分钟（0.83±1.29；P=0.007）还是 10 分钟（0.0±0；P=0.001）。与自动干燥相比，手动干燥后 48 小时（P=0.001）和 72 小时（P=0.014）时的 ATP 生物发光值更高。
与手动干燥相比，我们证明在自动干燥后内镜工作通道内的水滴明显减少，ATP 生物发光值延迟。特别是，在自动干燥 10 分钟后，内镜工作通道内几乎没有残留液体。这些发现支持尽可能自动化重新处理步骤的建议。自动干燥可能会降低与内镜相关的感染传播风险。
