Evaluation of disinfection processes for water heater devices used for extracorporeal life support

Perfusion ◽  
2019 ◽  
Vol 34 (5) ◽  
pp. 428-432
Author(s):  
Nicole Y R Shrimpton
Keyword(s):  
Heat Transfer ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Water Heater ◽  
Heating Unit ◽  
Water Filter ◽  
Plate Counts ◽  
Chloramine T ◽  
Heterotrophic Plate Counts ◽  
Water Borne

The Maquet Heater Unit 35 (HU35) is widely used to maintain patient body temperature during extracorporeal life support. Water is used as a medium for heat transfer though it also provides a medium for the growth of pathogens. Thus, the use of a heating unit presents a risk for transmission of water-borne pathogens in critically ill patients. Recently, a Mycobacterium chimaera outbreak in cardiac surgery has been linked to the production of bioaerosols by heater-cooler devices. Consequently, manufacturers have revised cleaning recommendations, with significant impact on staff, budget and environment. Heterotrophic plate counts (HPC) and non-tuberculous mycobacterium growth were assessed following three disinfection processes over a 16-month period. It was found that water quality was acceptable in HU35s when disinfecting with a lower concentration of Chloramine-T than currently recommended, provided exposure of the device to potential pathogens was minimised by the use of a 0.2 μm water filter.

scholarly journals Microorganism levels in spray from warm-water bidet toilet seats: factors affecting total viable and heterotrophic plate counts, and examination of the fluctuations and origins of Pseudomonas aeruginosa

2017 ◽  
Vol 16 (3) ◽  
pp. 346-358
Author(s):  
Toru Iyo ◽  
Keiko Asakura ◽  
Makiko Nakano ◽  
Kazuyuki Omae
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Tap Water ◽  
Viable Count ◽  
Warm Water ◽  
Water Heater ◽  
Reservoir Water ◽  
Advantages And Disadvantages ◽  
On Demand ◽  
Plate Counts ◽  
Heterotrophic Plate Counts

Abstract The objectives of this study were to conduct an appropriate microbial evaluation of warm-water bidet toilet seats. Health-related advantages and disadvantages have been associated with using warm-water bidet toilet seats, which are classified according to the tank type, including tanks equipped with reservoir water heaters and on-demand tankless systems equipped with an instantaneous water heater. However, related bacterial research is sparse. Here, we performed a long-term survey of the behavior of microorganisms (i.e., the total viable count (TVC), heterotrophic plate counts (HPCs), and Pseudomonas aeruginosa count) in a university campus. We also examined the differences between the tank and on-demand types, and the origins of P. aeruginosa. A low TVC (≤1/mL) in the spray waters from both on-demand and tank-type warm-water bidet toilet seats showed low bacterial contamination, although there was an increase in HPC, i.e., growth of biofilms, inside in the warm-water bidet toilet seats. When P. aeruginosa was detected in spray water over an extended duration, the P. aeruginosa origin was considered as either from feces or tap water. Collectively our findings demonstrate that hygienic safety of warm-water bidet toilet seats is being maintained overall.

Role of extracorporeal life support in thoracic surgery

2020 ◽  
Vol 99 (10) ◽  
Keyword(s):  
Thoracic Surgery ◽  
Extracorporeal Circulation ◽  
Life Support ◽  
Close Contact ◽  
Extracorporeal Life Support ◽  
Tumour Resection ◽  
R0 Resection ◽  
Malignant Tumours ◽  
En Bloc ◽  
Frequent Use

Besides the conventional extracorporeal circulation, commonly used in cardiac surgery, the methods of extracorporeal life support (ECLS) have been applied ever more frequently in thoracic surgery in recent years. The most commonly used modalities of such supports include extracorporeal membrane oxygenation (ECMO) and the Novalung interventional lung assist device (iLA). Successful application of ECLS has led to its more frequent use in general thoracic surgery, especially as a tool to treat hypercapnia and to ensure oxygenation and haemodynamic support. However, these methods are essential in lung transplant programmes; without their help, in most cases, it would not be possible to perform the transplantatioz or prevent the severe complications associated with critical primary graft dysfunction. Additionally, the extracorporeal circulation also facilitates the performing of specific surgical procedures that would not be feasible under standard conditions or would be associated with an inadequate risk. The application of extracorporeal life supports can fundamentally increase the level of resection when treating advanced intrathoracic malignancies that are in close contact with the heart and large vessels or even directly extend into them. Without the possibility of resecting such structures en bloc, together with the tumour, and, thus, achieving an R0 resection, these malignant tumours are often directly contraindicated for surgery or are operated non-radically, i.e. unsuccessfully. Complete tumour resection is the most important prognostic factor in the surgery.

Diagnosis of coronary affection in patients with AADA and treatment of postcardiotomy myocardial failure using extracorporeal life support (ECLS)

2014 ◽  
Vol 17 (5) ◽  
pp. 253 ◽  
Author(s):  
Sabina P W Guenther ◽  
Sven Peterss ◽  
Angela Reichelt ◽  
Frank Born ◽  
Matthias Fischer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Artery Bypass ◽  
Preoperative Evaluation ◽  
Left Heart Failure ◽  
Myocardial Failure ◽  
Coronary Abnormalities ◽  
Ventricular Support

<p><b>Background:</b> Myocardial ischemia due to concomitant coronary artery disease (CAD) or coronary dissection in patients with acute aortic dissection type Stanford A (AADA) is associated with myocardial failure and poor outcomes. Preoperative coronary angiography in this group of patients is still debated. The use of CT scan to diagnose coronary affection along with the establishment of high-pitched dual-spiral CT protocols are essential for improving outcomes.</p><p><b>Methods:</b> We retrospectively analyzed six AADA patients with heart failure who were treated using extracorporeal life support (ECLS). Options for diagnosing coronary affection and different therapeutic strategies for postcardiotomy cardiogenic shock in this patient cohort are discussed.</p><p><b>Results:</b> Retrospective review of CT images showed coronary abnormalities in 83% (n = 5). Four patients (67%) underwent unplanned coronary artery bypass grafting (CABG). ECLS was instituted in 67% (n = 4) due to left heart failure and in 33% (n = 2) due to right heart failure. Thirty day mortality was 67% (n = 4). The two patients that received ECLS for right ventricular support survived and both had undergone CABG.</p><p><b>Conclusion:</b> Besides preoperative evaluation of the extent of the dissection, focus on coronary affection in CT-scans helps to triage the operative procedure. Hybrid operating rooms allow for immediate interventional and/or surgical treatment and enable for immediate control of revascularization results. The use of ECLS over other types of ventricular support systems may allow for myocardial recovery in selected cases.</p>

Sign in / Sign up

Export Citation Format

Share Document