PubMed · 8536101
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D Pennell. 1995. Chemical caution.. https://pubmed.ncbi.nlm.nih.gov/8536101/
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This paper analyses the evolution of hypochlorite as strong disinfectant. The electrochemical production of hypochloric acid or sodium hypochlorite represents the best method to obtain a pure product. To have a good production (as quality and quantity), it is necessary to optimize the electrochemical process with the optimal of electrocatalytic electrodes (cathode and anode) the gap between electrodes, the temperature of electrochemical cell. It is very important for the product stability during a long period, avoid the presence of heavy metal ions and particulate as impurity-like carbon micro-powders in suspension. It is necessary a rigorous control of the pH of final product to have the optimal disinfection power of hypochlorite solution. The most stable sodium hypochlorite solutions are those that show the following characteristics: (1) low concentration of hypochlorite; (2) pH -> 11.5 and <13; (3) absence of graphite particulate and metallic ions; (4) storage at controlled temperature <30 degrees C. Packing in containers impermeable to light.
In recent years the concept of biocompatibility is not limited to the dialytic membranes, but has been substituted by a more general viewpoint where all the parameters of the dialytic treatment are taken into consideration: the interaction of blood-surfaces (the dialyzer in all its components and the hematic lines), the sterilization of all materials, the quality of the solutions utilized for dialysis and reinfusion. Numerous studies have shown that the inflammatory response in dialysis is the cause of many of the side effects of dialytic treatment itself both acute and chronic. Hypoxemia, 'first use' syndrome, hypotension, allergic-anaphylactic reactions (short-term side effects); microinflammation, malnutrition, accelerated arteriosclerosis, anemia, beta2 microglobulin amyloidosis, immunodeficiency, bone mass loss (long-term side effects), have all been reported. In this review, we will focus on the fluids utilized for hemodialysis (HD) and hemodiafiltration (HDF); we will describe the process of disinfection of the machines which produce the dialytic solutions.
Peritoneal dialysis (PD) exchanges require sterile equipment, supplies, and technique. Sterility may be maintained with single use. However, when equipment such as lines and transfer sets are used repeatedly, disinfection techniques become a critical aspect in preventing infectious complications. Techniques available for disinfection of lines and transfer sets in PD will be reviewed.