[Technical requirements for buying a heat and humidity exchanger for ventilation during anesthesia. French Society of Anesthesia and Intensive Care]. / Clauses techniques pour l'achat d'un filtre échangeur de chaleur et d'humidité destiné à la ventilation en anesthésie. Société française d'anesthésie réanimation.

To prevent cross infection and to improve the management of anaesthetic circuits, the French society of anesthesia and intensive care recommended the use of heat and moisture exchange filter (HMEF). Buying a HMEF needs a procedure with different steps and a product request form must delineate precise needed requirements of the device. In the absence of standardized methods to assess filtration performance, required specifications are established from both manufacturer data and scientific published studies. Proposed purchasing method and criteria help the health care workers at the time of final decision for objective comparison between the different devices on the market.

[Indicators of quality for hospital antisepsis]. / Indicateurs de qualité pour l'antisepsie à l'hôpital.

In any health care institution, the most important quality indicator for antisepsis is the existence of systems of reference of use, secondly the knowledge of those systems and then the compliance by the different classes of professionals. These refrentials must be regularly evaluated and updated according to general consensus.

Quantitative determination of endotoxins released by bacterial biofilms.

Residual endotoxins, commonly associated with bacterial biofilms colonizing reusable medical devices have been associated with pyrogenic reactions in patients. We have used a quantitative, sensitive and reproducible kinetic chromogenic adaptation of the Limulus Amebocyte Lysate assay to assess endotoxin recovery from an in-vitro bacterial biofilm. The 'recovery method' was based on a combination of physical treatment (vortexing and sonication) and chemical treatment (immersion in recovery solution). Five recovery solutions were investigated. The recovered endotoxin was greater when the biofilm was treated with a 1% SDS solution. The sensitive and reproducible method we have developed should allow the recovery and measurement of biofilm bacterial endotoxins on implanted and colonized medical devices. Moreover, the amount of endotoxin was sufficient (> 1000 endotoxin units/cm2 of substrate) to enable a substantial reduction by sterilization processes, the efficiency of which on biofilm endotoxins has yet to be proven.

[Sterilization of biocompatible materials: which method to choose?]. / La stérilisation des biomatériaux: quelle méthode choisir.

Sterilization of biomaterials, in hospitals, must be considered as the re-sterilization (and not reuse) of devices: prostheses, implants, catheters... This practice is not allowed, according to the circular of may 14 th, 1986; however it is a necessity in various cases. It must be realised with an extreme care, after evaluation of the different methods of sterilization: steam, dry-heat, ethylene oxide, formaldehyde or ionizing radiations and of their effects on the behaviour of the biomaterial.