ABSTRACT
BACKGROUND: Needleless connectors (NCs) can be disinfected using antiseptic barrier caps (ABCs) to reduce the risk of catheter-related bloodstream infections. However, recent evidence suggests that isopropanol can leak from the ABC into the NC, posing concern about their safe use. We sought to determine in vitro which ABC and NC parameters influence the leakage of isopropanol through the infusion circuit. METHODS: We assessed 13 NCs and 4 ABCs available in the European market. In vitro circuits consisting of an isopropanol cap, a NC, and an 11-cm catheter line were created. The circuits were left in place for 1 to 7 days at room temperature to assess the kinetics of isopropanol leakage. Isopropanol content in ABC and in circuit flushing solutions (5 mL NaCl 0.9%) after exposure to the cap were measured using gas chromatography with a flame ionization detector. RESULTS: The leakage of isopropanol from the cap to the NC was dependent on the NC, but not the cap. The NC mechanism did not predict the leakage of isopropanol. The Q-Syte NC exhibited the most isopropanol leakage (7.01±1.03 mg and 28.32±2.62 mg at 24 hours and 7 days, respectively), whereas the Caresite NC had the lowest isopropanol leakage at 7 days (1.69±0.01 mg). CONCLUSION: The use of isopropanol ABCs can cause isopropanol leakage into the catheter circuit according to NC parameters. Caution should be exercised when using these devices, especially in the pediatric and neonatal population.
Subject(s)
2-Propanol , Anti-Infective Agents, Local , Infant, Newborn , Humans , Child , Catheters, Indwelling , Equipment ContaminationABSTRACT
As global vaccine production capacity is limited, every optimization strategy must be explored to rapidly increase the number of people vaccinated. The objective of this study is to determine which medical devices allow the extraction of the maximum number of doses from different vaccine vials (Pfizer-BioNTech, AstraZeneca, Moderna and Johnson & Johnson vaccines) by analyzing all the factors involved in the preparation of the injected doses. By measuring the dead-volume of 32 syringe-needle combinations, we show that fixed-needle syringe with a dead-volume of less than 5 µL can extract up to 7 doses from Pfizer vials, 13 doses from AstraZeneca vials, 12 doses from Moderna vials and 6 doses from Johnson & Johnson vials. We found that the syringe accuracy is important, and can compromise the chances of extracting additional doses when withdrawing too large a volume. For Pfizer vaccine, particular attention must be paid to the choice of dilution syringe, which may compromise the extraction of the 7th dose. The withdrawal of extra doses from vaccine vials was not operator-dependent. In this unprecedented health context, the medical device considerations presented here could help to optimize every COVID-19 vaccine vial.
Subject(s)
COVID-19 , Syringes , COVID-19 Vaccines , Humans , Needles , SARS-CoV-2ABSTRACT
Hydrocellular dressings have evolved considerably over the last 25 years. Manufacturers have worked to increase their absorbency, to make them easier for caregivers to use and to improve their comfort for the patients. This class now comprises a diverse range of dressings. Their inclusion on the list of products and services approved for reimbursement, given the low level of evidence provided by the clinical studies currently available, depends on their technical characteristics assessed in vitro.
