Department of Medical Engineering, National Hospital Organization Kure Medical Center, Kure, Hiroshima, Japan.
Department of Nephrology, National Hospital Organization Kure Medical Center, Kure, Hiroshima, Japan.
Int J Artif Organs. 2021 Jun;44(6):385-392. doi: 10.1177/0391398820975034. Epub 2020 Nov 21.
A hemodialysis room has pipes connecting the console and central fluid equipment. While these pipes require disinfection, reports detailing disinfection strategies are unavailable. Therefore, we aimed to compare two easy disinfection strategies differing in sanitization frequency and sanitizer concentration.
Reverse osmosis water (ROW) purifying equipment and six dialysis consoles were connected by 20 m of pipes. Only ROW flowed through these pipes, because the dialysate solution was constituted at each console. The pipes were sanitized by two strategies: (1) strong and monthly (hypochlorite concentration: 100 ppm) or (2) weak and weekly (5 ppm). Both strategies were easy because the sodium hypochlorite was simply added to the ROW tank. To estimate sanitization efficacy, endotoxin counts at the ROW tank outlet, the end of the pipe, and the pipe after the endotoxin-cutting filter in each console were measured monthly for six continuous months. These counts were compared between the two sanitization strategies.
The endotoxin counts at the ROW tank outlet and the end of the pipe were 0.004-0.017 and 0.012-0.081 EU/mL, respectively, in the strong and monthly strategy, and 0.001-0.003 and 0.001-0.005 EU/mL, respectively, in the weak and weekly strategy. The endotoxin counts at the pipe after the endotoxin-cutting filter were less than 0.001 EU/mL during the study period in both strategies.
A weekly disinfection strategy was more effective than a monthly one, despite the lower hypochlorite concentration. The present study suggests that frequency is the most important factor in the disinfection of pipes in a dialysis room.
血液透析室的控制台和中央液体设备之间有连接管道。虽然这些管道需要消毒，但目前尚无详细的消毒策略报告。因此，我们旨在比较两种不同消毒频率和消毒剂浓度的简单消毒策略。
反渗透水（ROW）净化设备和六台透析控制台通过 20 米长的管道连接。只有 ROW 通过这些管道流动，因为每个控制台都构成了透析液溶液。通过两种策略对管道进行消毒：（1）强且每月（次氯酸钠浓度：100ppm）或（2）弱且每周（5ppm）。两种策略都很简单，因为只需将次氯酸钠添加到 ROW 罐中。为了评估消毒效果，每月测量连续六个月的 ROW 罐出口、管道末端和每个控制台内的内毒素切割过滤器后的管道中的内毒素计数。比较了两种消毒策略之间的这些计数。
在强且每月策略中，ROW 罐出口和管道末端的内毒素计数分别为 0.004-0.017 和 0.012-0.081EU/mL，在弱且每周策略中，分别为 0.001-0.003 和 0.001-0.005EU/mL。在研究期间，两种策略中内毒素切割过滤器后的管道内的内毒素计数均小于 0.001EU/mL。
尽管次氯酸钠浓度较低，但每周消毒策略比每月消毒策略更有效。本研究表明，频率是透析室管道消毒的最重要因素。
