Hydrophilic Catheters Research Articles

Recycled RRIM in sandwich panels

Single-use medical devices have been under close scrutiny for several years, especially the choice of plastic materials. Many different requirements such as medical safety, treatment functionality and efficiency, environmental performance, etc. have to be fulfilled. Today, the most commonly used materials for hydrophilic urinary catheters are polyvinylchloride (PVC) and thermoplastic polyurethane (TPU). In this research study, these two materials' environmental performance was evaluated. In light of the knowledge gained in that study a new plastic material for use in urinary catheters was developed. The aim of the development of this new material was to design a high performance material with superior environmental performance. The newly developed plastic material is a polyolefin-based elastomer. The ecological environmental performance of the new material was evaluated and compared to the existing plastic materials. The study focused exclusively on the choice of plastic materials and their ecological environmental performance.The analysis has been performed using a system perspective and a life cycle assessment (LCA) methodology. The functional unit has been set to the treatment of one patient during one year. The results from the LCA models have been presented both in terms of direct inventory data, such as energy use and formed emissions, and in terms of the results from four different impact assessment methods. Analysis of the results based on direct inventory data, i.e. common inventory results such as energy resource uses and emissions of CO2, NOx and SO2 show an overall better environmental performance for the new polyolefin-based elastomer compared to the existing PVC and TPU plastic materials. The normalization and weighting steps in the analyzes have indicated the importance of energy resource uses and global warming as indicator for the environmental performance even if other impact categories also can play a role. In the environmental impact assessment, the polyolefin-based elastomer showed a clearly better environmental performance than the TPU material. Compared to PVC plastic material the new polyolefin-based elastomer showed an almost equivalent environmental performance. This can be mainly explained by the different materials' energy use. The new material has thus also shown to be an environmentally good alternative to PVC if a PVC-free material is requested. Basing the plastic formula, on simple bulk plastics with low energy use in the production of single-use medical devices, has been shown to be a successful method of producing high quality products with superior environmental performance.

Efficacy and Safety of Clean Intermittent Catheterization in Adults

A prospective study was carried out on the efficacy and safety of clean intermittent catheterization (CIC). The series included 41 adults (15 females, 26 males), the mean follow-up time being 40 months. Most patients were suffering from neurogenic bladder disorders. All of them used a self-lubricating hydrophilic catheter. Thirty-one patients (76%) continued to undergo CIC, but 9 discontinued. Thirty patients (73%) experienced bacteriuria during the procedure. Three males had epididymitis. Contrary to many earlier reports, urinary tract infections seem to increase after CIC, raising the question of whether prophylactic antibiotic therapy should be used more often in these cases. There were no urethral complications suggesting that the self-lubricating hydrophilic catheters may be less traumatic than those used previously.

Bacterial Adherence to Urethral Catheters

Closed sterile catheter drainage has markedly reduced the incidence of nosocomial urinary tract infections. Infections that occur during closed drainage must ascend by colonizing the catheter or urethra. Our study compared adherence by different bacterial species to different catheter surfaces. We found no bacteria adhering to the hydrophilic catheter surface. Of the gram-negative bacteria Proteus mirabilis showed the greatest adherence to the other catheters and it, like most bacteria, showed the most marked adherence to the red rubber catheter.

Is the deterioration of liver viability due to hepatic warm ischemia or reinflow of pooled-portal blood in intermittent portal triad cross-clamping?

The effects of hepatic warm ischemia and portal pooling on the viability of the liver were investigated with respect to hepatic energy metabolism by performing intermittent portal triad cross-clamping (Pringle's maneuver) on dogs with or without portosystemic shunt. The dogs were divided into two groups of five: Group 1, non-shunt group, underwent Pringle's maneuver performed for 30 min and declamping for 30 min, a process that was repeated five times; and Group 2, shunt group, underwent the same procedure as Group 1, except for portosystemic shunt using a heparinized hydrophilic catheter between the splenic and jugular veins. The shunt was opened during Pringle's maneuver and was closed immediately at declamping. In the non-shunt group, portal pooling increased and systemic blood pressure decreased when Pringle's maneuver was performed, but in the shunt group portal and systemic blood pressures remained within the normal range. In the non-shunt group, the initial velocity of arterial blood ketone body ratio (KBR) recovery after each declamping significantly (P less than 0.01) decreased from 0.122 +/- 0.016 (per min) after the first declamping to 0.028 +/- 0.017 (per min) after the fifth declamping. Hepatic energy charge [= (ATP + 1/2 ADP)/(ATP + ADP + AMP)] decreased from 0.840 +/- 0.003 before ischemia to 0.749 +/- 0.003 30 min after the fifth declamping (P less than 0.001). The concentrations of lactate and total amino acids in arterial blood increased. On the other hand, in the shunt group, the initial velocity of KBR recovery and hepatic energy charge showed little change even after the fifth declamping (0.081 +/- 0.016 per min and 0.851 +/- 0.009, respectively). The concentrations of lactate and total amino acids showed almost no increase. The impairment of hepatic energy metabolism by intermittent portal triad cross-clamping is mainly due to reinflow of pooled-portal blood to the previously ischemic liver, rather than hepatic warm ischemia. The KBR may be useful for determining the degree of impairment of hepatic energy metabolism.

Temporal portasystemic bypass with the use of the heparinized hydrophilic catheter

Temporal portasystemic bypass with the use of the heparinized hydrophilic catheter

Comparison of Hydrophilic Polymer-coated Latex, Uncoated Latex and PVC Indwelling Balloon Catheters in the Prevention of Urinary Infection

Latex, hydrophilic polymer-coated latex and PVC balloon indwelling urethral catheters were compared in respect of the urinary tract infections arising in association with their use in male patients. The polymer (Hydron) coating conferred no benefit over uncoated latex which in turn was indistinguishable from PVC. No significant differences in the spectra of infecting organismns were observed between the 3 catheter types.