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Vol. 14. Issue 4.
Pages 380-384 (July - August 2010)
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Vol. 14. Issue 4.
Pages 380-384 (July - August 2010)
Review article
Open Access
Recommendations for hygiene of masks and circuits in mechanically home ventilated patients
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Michel Toussaint1,
Corresponding author
michel.toussaint@inkendaal.be

Correspondence to: Centre for Neuromuscular Disease, and Centre for Home Mechanical Ventilation UZ-VUB-Inkendaal; Rehabilitation Hospital Inkendaal, Inkendaalstraat, 1; 1602 – Vlezenbeek – Belgium. Tel.: +32-2-5315111; fax: +32-2-5315301
, Gregory Reychler2
1 Centre for Neuromuscular Disease, and Centre for Home Mechanical Ventilation UZ-VUB-Inkendaal; Rehabilitation Hospital Inkendaal, Vlezenbeek, Belgium
2 Department of Physical Medicine and Rehabilitation, and Centre for Cystic Fibrosis, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Abstract

Home mechanical ventilation requires equipment, consisting of a generator of pressure, a tubing and an interface to deliver air to the patient. Instructions for equipment maintenance are generally not based on scientific evidence. Studies however have reported that tubing and masks used at home are the most commonly found as very dirty and contaminated. Dirtiness and contamination of equipment potentially expose patients to a higher risk of airway colonization, which, in turn, should cause respiratory infections. For this reason, published hygiene instructions include the use of disinfectant solution. Nevertheless, they generally fail to explain how basic maintenance may be achieved by simple cleaning with soap and water. The instructions for post-cleaning disinfection will depend upon the relative sensitivity of patients to respiratory tract infections and the related risks for bacterial colonization of the airways. Restrictive and obstructive disease patients are not equally sensitive to infections and, as a consequence, should not require similarly elaborate disinfection level. According with the restrictive or obstructive origin of respiratory insufficiency, the current educational review suggests simple and adequate rules for hygiene of tubing and masks in the home setting. Written instructions on how to clean the equipment for home ventilation are useful and sufficient in restrictive patients. In obstructive patients, cleaning always precedes disinfection. After cleaning, rinsing and drying are important. An effective weekly 20-minute disinfection may be achieved by using an hypochlorite solution of soaking in a concentration of 0.5%.

Keywords:
contamination
colonization
disinfection
home mechanical ventilation
hygiene
maintenance
non-invasive ventilation
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