Reprocessamento de cateteres de angiografia cardiovascular após uso clínico e contaminados artificialmente: avaliação da eficácia da limpeza e da esterilização.
Notice bibliographique
Résumé
The healthy assistance implies in risk, which can be maximized, minimized or projected based on the scientific data.The reprocessing of single used devices is a practice that each day has demanded efforts of the healthcare professionals in order to search and to produce scientific evidences to help them make decision in relation to not reuse or reuse under safety conditions.The objective of this study was to evaluate different cleaning processes and sterilization in ethylene oxide 100% of the angiographic catheters in order to determine the capacity in reducing of the bioburden and the organic residual before and after patient use, as well as in simulated use with soil test.It is an experimental research, comparative and controlled permed in the Research Centre of the Saint Boniface General Hospital affiliated to the University of Manitoba located in Winnipeg, Canada.The catheters had been used only one time for coronariographic exam and submitted to the analysis of organic residues (hemoglobin, carbohydrate, protein and endotoxin) by in situ and destructive test reading by spectrophotometer.The bioburden was evaluated by microbial culture.These experiments had been performed in four phases, being the first immediately after patient use to determine the basaline soil; the second after patient use and cleaning of the catheter by different methods; the third after patient use, soil test inoculation and cleaning by different methods.The fourth phase was performed after patient use and simulated reuse.Descriptive and analytical statistic analysis by parametric statistical tests (variance analysis) or no parametric tests (Kruskall-Wallis) were performed.Had been considered bilateral tests with a significance level < 0,05 and the confidence interval was 95%.It was considered clening failure of the cleaning process any positive results of the detention of organic and microbiological residue.The catheters were submitted to the following cleaning methods: manual washing with enzymatic detergent with tap water or reverse osmosis sterile rinsing; manual washing with hydrogen peroxide detergent rinsing in reverse osmosis sterile water, automated washing with no rinse or reverse osmose sterile water; hydrogen peroxide detergent pumping with tap water or reverse osmosis sterile rinsing .The results gotten in our study showed the maintenance of the bioburden before and after the cleaning of the catheters.In the baseline phase 8,2% of the cultures were positive cultures and the microbial load was 500CFU/device.After cleaning it was 8,3% and the average microbial load was 250 CFU/device.The baseline organic residues data were hemoglobin 146,3µg/device, protein 628,5 µg/device, carbohydrate 7,0µg/device and endotoxin 38,0EU/device.After five simulated use, the indirect hemoglobin concentration was lower of the test limit of detention, protein = 107,7 µg/device, carbohydrate = 340,1µg/device and endotoxin=5,4EU/device.The organic residual analysis according the cleaning methods found different levels of reduction.The cleaning methods that had used a hydrogen peroxide detergent showed better performance relating the enzymatic detergents methods, as well as hydrogen peroxide detergent pumping with
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».