Our hospital biomed has just told me after talking with Gambro that we can no longer flush dilute minncare solution through the intake lines of the machines with our monthly loop disinfects unless we use bleach. What is everyone else doing out there and with the portable ones for the acute unit RO's with dialysis machines?

Sounds strange to me since Minncare, Actril, and Renalin are all PAA.

Chuck

I would still go with PAA. You can't run bleach to a membrane.

Let me clarify. Gambro said we cannot use minncare to run from the loop into our machines; They said instead to use a special intake line adaptor to manually plunge a bleach disinfect solution in the intake line to the machine to sanitize it. I've been in dialysis for 20 years and i hae never heaqrd of not running disinfectant in the loop through the machines to drain.

I'm just guessing here....

"Minncare" is approved for disinfecting water systems whereas "Actril" is approved for disinfecting dialysis machines, even though they are both the same thing. Bleach is approved for both.

I asked a Minntech rep. about this years ago and was told that it is CHEAPER and easier to get FDA approval for a "new" product than it is to modify they approved uses of an existing one.

Chuck

There is a slight formulation difference between actril and minncare. I believe that the minncare has a lower percentage of hydrogen peroxide.

As "Loop" you mean R.O Water Distribution Loop and "Machine" you mean Dialysis Machine?

Or "Loop" domestic plumbing (feed to R.O) and "Machine" R.O Machine?

I have my CWP programmed with my Phoenix machines so that during hot water disinfect of the loop, the machines turn on, twice weekly during the night and perform a rinse with the hot water from the loop.this process gets the inlet water line.Works excellent

IMHO, Gambro, and just about all other machine manufacturers are playing the CYA game. In my experience they have never been on the same page as Minntech. Minntech recommends a certain dwell time and the machine manufacturer says you shouldn't dwell it that long. The provider is stuck in the middle. Do what it takes to control biofilm and bacterial growth. There have been enough discussions in this forum that point to alternating the use of more than one disinfectant in the loop. The only good bug is a dead bug and if it means using Minncare, Actril, bleach or whatever in the in-coming water line to the machine, so be it.

Very true remark Mr. Holloran. But dead bugs aren't good either :\. IMHO Dead bugs (Endotoxins) are "worse" than live bugs (Bacteria).

The machines are rinsed to clear out the disinfectant, shouldn't that also rinse out the dead bacteria? Additionally, they rinse all the machines on startup in the morning. If you have diasafe, wouldn't that prevent the endotoxins from reaching the dialyzer?

I was talking about his statement "the only good bug is a dead bug" not the machine capabilities.

s. augustine,

Absolutely true about the dead bugs being "undesireable". My point was that while the disinfectant companies and the machine companies are debating what to use and for how long, we the providers, are battling the bugs, alive and dead.

I have a Gambro RO unit and K machines and here I run the heated water from the heat disenfect of the distribution loop through the machines by putting all machines inti a 15min rinse, been doing this for the last 3 1/2 years with no issues

quote:

I've been in dialysis for 20 years and i hae never heaqrd of not running disinfectant in the loop through the machines to drain.

How could you NOT hear about that? I've been doing it for 20 years.