Reprocessamento de cateteres de angiografia cardiovascular após uso clínico e contaminados artificialmente: avaliação da eficácia da limpeza e da esterilização.
Bibliographic record
Abstract
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
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".