ASSURING PROPER GERMICIDE CONCENTRATIONS IN REPROCESSED HEMODIALYZERS

More than 50% of the outbreaks of infections and/or pyrogenic reaction s in chronic hemodialysis patients investigated by the Centers for Dis ease Control and Prevention (CDC) involved centers with manual dialyze r reprocessing programs. It is important, especially with manual repro cessing techniques, to ensure that proper concentrations of germicide are obtained in the dialyzer to prevent subsequent infections in patie nts. In addition, there may not be convenient test methods available t o indicate whether or not a dialyzer contains a sufficient concentrati on of disinfectant to prevent bacterial growth. We have demonstrated t hat dialyzers need to be filled with a total of four compartment volum es of the use-dilution of germicide to attain the appropriate concentr ation (at least 90% of the use-dilution) within the dialyzer as recomm ended by the Association for the Advancement of Medical Instrumentatio n (AAMI). An easy method of ensuring that dialyzers are filled with fo ur total compartment volumes is to measure the effluent with a graduat e cylinder during reprocessing. Concise reuse procedures and the use o f AAMI quality water for rinsing and preparation of disinfectant solut ions are crucial in preventing patient morbidity and mortality.