BACKGROUND AND AIMS Studies from our group and others demonstrate residual fluid in 42% to 95% of endoscope working channels despite high-level disinfection and drying. Additionally, persistent simethicone has been reported in endoscope channels despite reprocessing. METHODS Endoscopy was performed by using water or varied simethicone concentrations (0.5%, 1%, 3%) for flushing. After high-level disinfection/drying, we inspected endoscope working channels for retained fluid by using the SteriCam borescope. Working channel rinsates were evaluated for adenosine triphosphate (ATP) bioluminescence. Fourier transform infrared spectroscopy was performed on fluid droplets gathered from a colonoscope in which low-concentration simethicone was used. RESULTS Use of medium/high concentrations of simethicone resulted in a higher mean number of fluid droplets (13.5/17.3 droplets, respectively) and ATP bioluminescence values (20.6/23 relative light units [RLUs], respectively) compared with that of procedures using only water (6.3 droplets/10.9 RLUs; P < .001). Two automated endoscope reprocessing cycles resulted in return of a fluid droplet and ATP bioluminescence values to ranges similar to that of procedures that used only water (P = .56). Low-concentration simethicone did not increase the mean residual fluid or ATP bioluminescence values compared with procedures that used only water (5.8 droplets/15.6 RLUs). Fourier transform infrared analysis revealed simethicone in the endoscope working channel after use of low-concentration simethicone. CONCLUSIONS Use of medium/high concentrations of simethicone is associated with retention of increased fluid droplets and higher ATP bioluminescence values in endoscope working channels, compared with endoscopes in which water or low concentration simethicone was used. However, simethicone is detectable in endoscopes despite reprocessing, even when it is utilized in low concentrations. Our data suggest that when simethicone is used, it should be used in the lowest concentration possible. Facilities may consider 2 automated endoscope reprocessor cycles for reprocessing of endoscopes when simethicone has been used.

中文翻译：

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尽管进行了后处理，但二甲硅油仍保留在内窥镜中：其使用对工作通道中的液体保留和三磷酸腺苷生物发光值的影响（带视频）。

背景和目的来自我们小组和其他小组的研究表明，尽管进行了高水平的消毒和干燥，但仍有42％至95％的内窥镜工作通道中残留液体。此外，尽管进行了后处理，但仍在内窥镜通道中报告了持久性西甲硅油。方法使用水或不同浓度的二甲硅油（0.5％，1％，3％）进行冲洗以进行内窥镜检查。经过高度消毒/干燥后，我们使用SteriCam管道镜检查了内窥镜工作通道中是否有残留的液体。评估工作通道冲洗液的三磷酸腺苷（ATP）生物发光。对从使用低浓度西甲硅油的结肠镜收集的液滴进行傅里叶变换红外光谱。结果与仅使用程序相比，使用中/高浓度的二甲硅油可产生更高的平均液滴数（分别为13.5 / 17.3个液滴）和ATP生物发光值（分别为20.6 / 23个相对光单位[RLU]）。水（6.3滴/10.9 RLU； P <.001）。两个自动内窥镜后处理周期导致液滴和ATP生物发光值恢复到与仅使用水的程序相似的范围（P = .56）。与仅使用水（5.8滴/15.6 RLU）的程序相比，低浓度的二甲硅油不会增加平均残留液体或ATP生物发光值。使用低浓度的二甲硅油后，傅立叶变换红外分析显示内窥镜工作通道中的二甲硅油。结论与使用水或低浓度西甲硅油的内窥镜相比，中/高浓度西甲硅油的使用与内窥镜工作通道中液滴增加的保留和较高的ATP生物发光值有关。但是，尽管进行了后处理，即使在低浓度下使用二甲硅油，仍可在内窥镜中检测到。我们的数据表明，当使用二甲硅油时，应以尽可能低的浓度使用。使用二甲硅油时，设施可能会考虑2个自动内窥镜洗牙机循环，以对内窥镜进行后处理。尽管进行了后处理，但即使在低浓度下使用时，仍可在内窥镜中检测到二甲硅油。我们的数据表明，当使用二甲硅油时，应以尽可能低的浓度使用。当使用二甲硅油时，设施可能会考虑2个自动内窥镜洗牙机循环以进行内窥镜洗牙。尽管进行了后处理，但即使在低浓度下使用时，仍可在内窥镜中检测到二甲硅油。我们的数据表明，当使用二甲硅油时，应以尽可能低的浓度使用。使用二甲硅油时，设施可能会考虑2个自动内窥镜洗牙机循环，以对内窥镜进行后处理。