Maintenance of e-flow

Question

We were advised to use the product “ummonium” to disinfect the nebulizer (reservoir + mesh). On the other hand we do not hear that this product is not being recommended for use in several CF reference centers. Why not? Has this product been tested for efficacy? Many people report problems with maintenance of e-flow reservoir and mesh. We use ummonium since a long time and never had problems. On the contrary our reservoir and mesh last one full year.

Answer

Dear questioner,
Ummonium is a concentrated disinfectant for cleaning and disinfection of medical instruments. It contains substances that destroy bacteria, fungi, yeast, viruses and mycobacteria. The product is mainly used in hospitals, for disinfection of medical material.
There are no specific studies about the use of ummonium to clean and disinfect e-flow. Ummonium is a non caustic product but it is not certain that it cannot possibly damage the fine mesh of the e-flow. Ummonium 38 is very active against microorganisms. We know that the product is active against bacteria such as Pseudomonas.

In solution the product remains stable for 20 days. Reuse of the solution is not advised. Indeed on reuse a residue can be formed and the concentration of the product can be altered. That is why the solution should be renewed every day. This is costly.
For disinfection and sterilization of material there is thus no uniform answer. Another effective way of disinfection is cooking during 15 minutes after cleaning. This can be done in a sterilizer.
Essential in the maintenance of aerosol apparel is good maintenance. Cleaning, rinsing and drying. That way growth of bacteria, fungi, viruses and microbacteria is inhibited.
Nebulizer, mouth peace and other physio material (flutter, PEP, IPV set) should
1. be cleaned, rinsed and dried after every use
2. once a day, after the last use be disinfected

In practice this amounts to
1. after every use material should be cleaned: a+b+c+d+e

a. disassemble the parts
b. clean with warm water and a soft detergent (dish cleaner)
c. rinse thoroughly with warm water
d. dry thoroughly with a paper towel
e. wrap the material in a dry paper towel and store in a dry and clean environment

2. once a day disinfect the material in this order: a+b+c+disinfect+d+e

This procedure has proven efficacy. In addition it is cheap and not damaging for the mesh of the e-flow.
Yours sincerely,
K. De Boeck

21.02.2011