Hypochlorite/degreasing

[fraser gilmour]

I'd be interested to know how many renal services are still performing regular bleach cleaning cycles, and what dialysis machines are being used.
It is still a recommendation in the user manuals for both our Fresenius and Nipro conventional machine types when using high flux dialysers, and as a manual flush periodically for the NXstage system. However we moved away from using bleach some years ago on the conventional machines, both in-centre and at home locations, with out any apparent problems. My assumption is that doing hot citric rinses post treatment in our circumstance on the conventional machines is enough to maintain proper operation. As the NXstage has no other means of disinfection/degreasing then a regular squirt of household bleach is enough to keep the drain line clear.
Interested to hear others thoughts on this.
 
       

[Garry]

Not regular, as in post every treatment, but our HDF equipment does require a disinfection with a strong hypochlorite (amongst other chemicals) based solution before replacement of ultrafilters.  Saying that I understand the company are looking to move away from this requirement, with the current model not needing it.  We have only every used a routine hot citric disinfection and have never seen any unwanted equipment deposits in 20 years.

The main drainage at some of our units certainly clogs up with white/brownish organic matter.  I’m sure routine bleach would address this.  Other units are fine, so I suspect the drainage/media panel design/flow rates are also having an impact.

[Gareth Murcutt]

We've only ever used citrosterile on our 4008s and 5008s since circa 2000. Never seen any ill effects at all. We only use Sporatol after an internal blood leak.