WO2018133896A1 - Method and disinfection device for disinfecting liquid circuits in a machine, in particular for water circuits in a hypothermia machine - Google Patents

Abstract

The invention relates to a method for disinfecting liquid circuits (14, 15) in a machine (1), in particular water circuits (14, 15) in a hypothermia machine (1). In the method: the liquid (19) of the liquid circuit (14, 15) is at least intermittently conducted for disinfection through a disinfection device (5) which has a device (2) for providing a disinfection fluid (18); the disinfection fluid (18) is added to the conducted liquid (19), and the liquid (19) is disinfected by the disinfection fluid (18) in a deactivation unit (3); the disinfected liquid (19) is then conducted into an elimination unit (4) for eliminating the disinfection fluid (18), in which the disinfected liquid (19) remains or through which the disinfected liquid (19) passes until the disinfection fluid (18) has been completely eliminated from the disinfected liquid (19) by the elimination unit (4), wherein at least one detection device (11) continuously monitors the degree to which the disinfection fluid (18) has been eliminated from the disinfected liquid (19), and the disinfected liquid (19) is only conducted back into the liquid circuit (14, 15) of the machine (1) after complete elimination of the disinfection fluid (18) has been established. The invention also relates to a corresponding disinfection device (5).

Description

 Method and disinfection device for disinfecting fluid circuits in a device, in particular for water circuits in a hypothermia device

description

The invention relates to a method for disinfecting fluid circuits in a device, in particular water circuits in a hypothermia device according to the preamble of claim 1 and a disinfecting device for disinfecting fluid circuits, in particular water circuits in a hypothermia device according to the preamble of claim 16.

Postoperative infections after cardiac surgery are feared complications. In modern operating rooms considerable technical effort (ventilation systems, lock systems, etc.) and organizational effort (personal hygiene, sterile surgical clothing) are operated to minimize the risk of nosocomial infections. To perform open heart surgery, the patient must be connected to a heart-lung machine. For the duration of the operation, his blood is oxygenated and decarboxylated in an extracorporeal circuit. At the same time, the blood temperature must be regulated to prevent the patient from cooling down or to cool the blood for complex surgery. The blood temperature control takes place in capillary heat exchangers in which the blood flows on one side and water on the other side as the heat transfer medium. The water in turn is tempered in a so-called hypothermia device, which may be considered as a separate hardware in addition to the heart-lung machine, in the range of about 2 ° C to 40 ° C. This combination of devices creates a water cycle in the cardiac surgical operating room, in which water circulates pump-driven during the operation or is in tanks inside the hypothermia device.

Hypothermia devices are mobile and, with regard to the water supply, autonomous multi-circuit heating or cooling devices. They are used as intended during one Extracorporeal perfusion for controlled temperature control of the patient and cardioplegic circulation using heat exchangers, usually integrated in oxy- genators. Without the ability to temper the patient's blood in a controlled manner, performing cardiac surgery is impractical. The devices are therefore obligatory and indispensable. The oxygenators are connected to the hypothermia device using DVGW-approved hoses. Commercially available Hansen couplings (plastic or metal) including hose clamps are used for the connection.

Water cycles tend, as known from the air conditioning and the food industry, for microbiological contamination. Depending on the temperature level within the hypothermia device (often at 37 ° C), the microorganisms find ideal growth conditions and can multiply uncontrollably. A major problem in clinical operation is the occurring after a few days of contamination of the usual heat transfer fluid water or the emergence of a biofilm on the entire, wetted inner surface of the pipes and containers. This contamination usually occurs even in cases where the Cleaning the hypothermia device has been carried out according to the maintenance plan.

Contrary to all hygiene measures, there is a kind of bioreactor in each cardiac surgical operating room, from which a potential patient hazard arises in the event that contaminated water within the hypothermia device leaks out of the water cycle in an improper way. In 2015, severe postoperative infections following cardiac surgery caused by Mycobacterium chimaera, whose provenance could be detected from hypothermia, were reported. The hazard was confirmed by various national health authorities by issuing appropriate warnings. These therefore recommend operators and users in the sense of precautionary health protection as a risk-minimizing interim measure to operate all corresponding hypothermia devices spatially separate from the operating theater. If this is not possible, it should be ensured in another appropriate way that the risk of infection is effectively minimized. However, the spatial distance to the operating field alone does not understandably reduce the microbiological burden on the water cycle. At present, manufacturers have specifications for complex ge disinfection and cleaning measures for the Hypothermiegeräte, but it is not known whether they can ensure even if strictly observed also a long-term sterility of the hypothermia devices.

Chemical additives or filters could be used to avoid these unwanted impurities in the heat transfer circuit.

However, the use of chemical additives is either cumbersome to use, material damaging, ineffective or even dangerous for patients and the surgical staff. To make matters worse, that manufacturers of oxygenators, in which the heat exchange between blood and water via a capillary heat exchanger, strictly prohibit the addition of disinfectants to the water cycle, since it can not be ruled out sure that a migration of chemical disinfectant constituents takes place in the blood.

Filters in turn prevent the growth of germs and algae. Since the filter life depends on the degree of contamination of the water-bearing system, a regular, costly replacement is required. In addition, a loaded filter significantly increases the flow resistance of the overall system, which can result in an unacceptable reduction in heat exchanger efficiency.

From DE 20 2004 001 194 U1 an auxiliary unit for hypothermic devices is known, in which a reduction of contamination or Veralimierung the heat transfer fluid water in hypothermic equipment is achieved in that the water passes through a UV-C sterilization device. The problem here is the high dose of UV radiation that is necessary for disinfection, since the hoses and other aggregates in the field of UV radiation against this must be extensively secured.

The object of the present invention is therefore to provide an if possible manufacturer-neutral disinfection device for devices through which water flows, in particular for hypothermic devices, which permanently makes it possible to reduce the microbiological load in the water cycle. The solution of the object of the invention results in terms of the method of the characterizing features of claim 1 and in terms of the disinfecting device from the characterizing features of claim 16 in cooperation with the features of the associated preamble. Further advantageous embodiments of the invention will become apparent from the dependent claims.

The invention in terms of the method is based on a method for disinfecting liquid circuits in a device, in particular water circuits in a hypothermia device. Such a method is further developed according to the invention in that the liquid of the liquid circulation for disinfection is at least temporarily passed through a disinfection device having a means for providing a disinfecting fluid, the disinfection fluid added to the liquid passed through and the liquid in a deactivation unit by the disinfecting fluid The disinfected liquid is then passed into an elimination unit for eliminating the disinfecting fluid in which the disinfected liquid remains or the disinfected liquid passes through until the disinfecting fluid is completely eliminated from the disinfected liquid by the elimination unit at least one detection device continuously checks the degree of elimination of the disinfecting fluid from the disinfected fluid, and only after festivals If the disinfecting fluid is completely eliminated, the disinfected fluid is returned to the fluid circuit of the unit. An essential feature of the invention is that the sterilized liquid after leaving the disinfecting device according to the invention contains no residues of the disinfecting fluid used for disinfection and therefore can not cause any impairment of the function of the device within the device or the liquid has no components derived from the disinfection, which can cause problems in connection with the use of the device. For example, in Hypothermiegeräten this can be reliably prevented that disinfection residues pass through leaks in the heat exchanger of the oxygenator in the blood of a patient and can cause harmful reactions there. This disinfection concept with its constructive implementation can be used in principle for all devices with liquid circuits, in which a microbial contamination hinders or has to be reduced. However, particularly advantageous is the application of the method in the medical field, since microbial contamination in the surgical area can have particularly serious consequences here. Due to the fact that the disinfecting fluid does not leave the disinfecting device and the liquid circuit (s) of the device passes through the disinfecting device as required or only occasionally, the device can remain completely unchanged in terms of its construction and functioning and does not need to be specially tuned or designed for interaction with the disinfecting device become. Thus, the method and the corresponding disinfection device, especially for the interaction with existing devices or the manufacturer-neutral retrofitting of existing devices offers.

The process can be carried out particularly advantageously if the disinfectant fluid used is a readily degradable fluid, in particular ozone, which permanently inhibits the microbiological load, in particular the multiplication of bacteria, fungi and algae, in the liquid to be disinfected. Ozone efficiently reduces the bacterial count in liquid circuits of a general nature and in particular in the water cycle of hypothermic devices to such an extent that the requirements of the German Drinking Water Ordinance are complied with. At the same time, the process ensures complete elimination of the ozone in the water by means of technical measures, before it is returned to the device, in particular the hypothermia device. The disinfection process effectively works on bacteria, fungi and algae, which account for most of the microbiological burden in the water cycle. The procedure is compatible with all hypothermic devices used in cardiac surgery worldwide. With ozone or other conceivable disinfecting fluids such as disinfectant liquids or disinfectant gases in a further embodiment, a log3 disinfection of the liquid is possible, i. that 99.99% of all microbiological contamination from the fluid circuit of the device can be killed or rendered harmless.

It is particularly advantageous if the device for providing a disinfecting fluid itself generates the disinfection fluid, preferably ionizing air from the environment to ozone. This avoids the disinfection device being In addition, the operation of the disinfection device is simplified on a regular basis with potentially harmful substances for the user.

In a further embodiment, the disinfecting fluid, preferably by means of an injector, at least a partial volume flow of the liquid of the fluid circuit can be added. Such an injector distributes the disinfecting fluid relatively evenly within the liquid to be disinfected, so that the disinfecting fluid can be safely brought into contact with any part of the liquid to be disinfected. However, it is also possible that the added disinfectant fluid is mixed with the fluid of the fluid circuit, e.g. via corresponding additional mixing devices or a suitable liquid guide.

It is particularly advantageous if the deactivation unit for the disinfection of the liquid is dimensioned and the liquid flows through it in such a way that the liquid is safely disinfected during the flow through the deactivation unit. Each disinfecting fluid needs for a reliable disinfection and depending on the desired degree of disinfection a certain exposure to the liquid to be disinfected, which is why the leadership of the liquid to be disinfected must remain correspondingly long in the deactivation unit or must go through several times a shorter designed deactivation unit. By appropriate choice of the length of the pipes within the deactivation unit and a corresponding volume flow of the liquid, this can be easily guaranteed.

Furthermore, it is conceivable in another embodiment that in the elimination unit ultraviolet radiation is used to decompose and degrade the ozone after disinfecting the liquid. Ozone, as a preferred disinfecting fluid, is decomposed by the action of UV light into innocuous components which can remain in the liquid circuit and no longer have harmful effects on the fluid circuit of the device. This avoids complex devices for extracting residues of a non-residue disintegrating disinfection fluid and thereby ensures cost-effective operation of the disinfection device.

Should a single pass through the deactivation unit not be sufficient for a complete disinfection of the liquid, so can by appropriate Control the volume flow of the liquid by means of valves in front of and behind the deactivation unit the disinfected liquid are fed again and again the elimination unit until the elimination of the disinfecting fluid has been completed.

Of particular importance for ensuring a trouble-free operation of the device is that at least one detection device continuously determines the degree of elimination of the disinfecting fluid after flowing through the elimination unit. This ensures that non-eliminated disinfecting fluid leaves the disinfection device and is transported into the fluid circuits of the device, where the disinfecting fluid can have adverse effects, including destruction of the device. For this purpose, it is necessary that the return of the liquid is released into the liquid circuit of the device only if the at least one detection device determines that the disinfecting fluid has been completely removed from the disinfected liquid. In a further embodiment, this safe mode of operation can be realized in that the at least one detection device influences the flow of the disinfected liquid in such a way that upon detection of an incomplete elimination of the disinfecting fluid, the disinfected liquid is passed through the elimination unit again. Instead of returning to the liquid circuit of the apparatus, the liquid, which has not yet been sufficiently eliminated, is again supplied to the elimination unit one or more times, such that the elimination unit is e.g. UV light also causes the last remaining residues of the disinfecting fluid, e.g. eliminated by decomposition.

In a first embodiment, it is conceivable that the disinfection device continuously disinfects the fluid circuit of the hypothermia device during periods of non-use of the hypothermia device. In such periods of non-use, disinfection is particularly important to keep the hypothermia device germ-free for long periods of time. At the same time it is avoided that the disinfection device itself must also be used within the surgical area, as this would require far more extensive and complex approval procedures for the disinfection device. The disinfection device can for example be operated adjacent to the surgical area, for example in an adjoining room of the OP in which the hypothermia device is stored during periods of non-use.

Of particular importance especially in the medical field, it is when in case of power failure, the disinfection device is placed in an operating state in which the fluid circuit of the device flows past the disinfection device. This reliably prevents the disinfecting device from passing over the disinfecting fluid, e.g. into the hypothermia device and impaired its function or life endangered. For this purpose e.g. Valves at the inlet of the disinfection device designed so that they close when de-energized and shut off the passage of liquid from the liquid circuit of the hypothermia device in the disinfection device. Furthermore, a redundantly designed measuring and control technology as well as the double bypass circuit can continue to protect the operation of the disinfection device when the limit value for the disinfection fluid is exceeded, for example by carrying out a self-test of the elementary functional units of the disinfection device at each startup and that in the time to next use, the complete device and all lines are permanently flushed with a low flow rate of up to 1 l / min (standby mode with circulating water).

The invention with regard to the device further relates to a disinfection device for fluid circuits in a device, in particular for water circuits in a hypothermia, in which the liquid circuit of the device flows through the disinfection device at least temporarily, the disinfection device has a device for providing a disinfecting fluid, which provides the provided disinfecting fluid of the liquid in a deactivating unit, whereby the disinfecting fluid disinfects the liquid, followed by the deactivation unit is an elimination unit is arranged, in which the disinfected liquid enters and in which the disinfecting fluid is eliminated, wherein at least one detection means continuously checks the degree of elimination of the disinfecting fluid in the liquid and is associated with valve means such that the disinfected liquid only after complete he elimination is returned to the fluid circuit of the device back. The properties and advantages of such a disinfection device are already above to the invention Procedures have been presented in detail and therefore should be made to this extent fully reference.

Such a disinfection device according to the invention can advantageously only in times of non-use of the device, preferably the Hypothermiegerätes, with the liquid to be disinfected liquid circuit in liquid-conducting connection and be arranged for example outside of an operating room. Especially for the retrofitting or operation of the disinfecting device according to the invention, it is advantageous if the disinfecting device is connected as an additional unit to a hypothermia device, preferably looped between the flow and return of the hypothermia device. As a result, any intervention in the operation of the hypothermia device is unnecessary, which could possibly cause regulatory problems and liability problems in addition to technical problems. However, it is also conceivable, e.g. For newly developed hypothermic devices a disinfection device according to the invention immediately as part of the hypothermia device and to provide a corresponding device integration.

Especially for the operation of existing hypothermic equipment, it may be useful that the volume of the liquid to be disinfected in the disinfecting device for the disinfection of a hypothermia device is no longer 1 I. This relatively small removal quantity of the liquid to be disinfected avoids the presence of fuses within the hypothermia device against excessively small quantities of liquid and interrupting the operation of the hypothermia device.

It is advantageous if the device for providing a disinfecting fluid, the disinfecting fluid is arranged in the flow direction of the liquid in front of the deactivation unit and, preferably by means of an injector such as a Venturi injector, at least a partial volume flow of the liquid adds the disinfecting fluid. On the one hand, this prolongs the exposure time of the disinfecting fluid and simultaneously improves the mixing of the liquid to be disinfected with the disinfecting fluid. Furthermore, it is conceivable that the device for providing a disinfectant fluid has an ionizer for generating the disinfecting fluid, in particular ozone from ambient air. As a result, an otherwise necessary filling of the disinfection device with, for example, ozone is superfluous, since the ozone can be generated by the ionizer in the disinfection device itself.

In the event that the disinfection of the liquid to be disinfected in a single pass through the deactivation unit can not be made reliably enough, it is conceivable that upstream and downstream of the deactivation unit controllable valves are arranged and controlled and connected to lines for the liquid that The liquid to be disinfected circulates through the deactivation unit until the liquid is safely disinfected. The double or multiple passage of the liquid to be disinfected thereby increases the exposure time of the disinfecting fluid and thereby the degree of disinfection.

Furthermore, it is of particular advantage if a radiation source for ultraviolet radiation is arranged in the elimination unit, which acts on the fluid mixed with disinfectant fluid and decomposes and degrades the ozone after disinfecting the fluid. For example, a de-ozonation of an ozone-water mixture by irradiation with 300-600 J / m ² by a UV lamp (254 nm) with a power of 3 to 30 W safely done. In addition to the degradation of the free ozone, the UV lamp also causes itself a disinfection. The flow rate in the circuits is eg between 5 and 25 l / min.

Again, it is conceivable to direct the liquid to be disinfected before and after the elimination unit by controllable valves so that the disinfected liquid circulates through the elimination unit until the disinfecting fluid is completely degraded in the disinfected liquid. Here, the already disinfected liquid, but possibly still has residues of the disinfecting fluid, several times the effect of the e.g. UV light that decomposes the ozone as a disinfecting fluid.

It is furthermore advantageous if the at least one detection device is arranged so that the detection device determines the degree of elimination of the disinfecting fluid after flowing through the elimination unit. At the exit from the elimination unit, the disinfecting fluid should normally be completely decomposed, so that the detection means no longer detects any disinfecting fluid in the disinfected liquid. However, if this is not the case for some reason, the flow of disinfected liquid can be directed by valves so that the disinfected liquid passes through the elimination unit once or several times again, based on the signal from the detection means, until the signal from the detection means completely eliminates the Disinfection fluid notes.

In order to increase the certainty that no residual disinfecting fluid is conveyed back into the device, in another embodiment, at least one further detection device can be arranged such that the degree of elimination of the disinfecting fluid is determined before the liquid is returned to the liquid circuit of the device. Only when both or all of the detection devices determine that there is no disinfecting fluid behind the elimination unit is the liquid returned to the fluid circuit of the device.

For the automated operation of the detection device, it is advantageous if the valves of the disinfection device can be adjusted by motor operation and are automatically influenced by a control device, preferably a programmable logic controller. This increases the reliability and simplifies operation. In a further embodiment, the control device can be connected to the device for providing a disinfecting fluid, the deactivation unit, the elimination unit, the at least one detection device, pumps and motor-operated valves and control the operation of the disinfection device.

Furthermore, care should be taken that the lines and other facilities of the disinfection device, which come into contact with the liquid to be disinfected, are resistant to the disinfecting fluid. All surfaces that may be in contact with the ozone-water mixture when using ozone as a disinfecting fluid should be ozone-resistant. Preferably, glass, plastic and / or stainless steel is used for the approximately spirally shaped containers and / or pipelines. A particularly preferred embodiment of the device according to the invention is shown in the drawing.

It shows:

Figure 1 - a schematic structure of the individual modules of the disinfection device according to the invention and the interconnection of the controller with the individual functional modules for the disinfection of a hypothermia device outside an operating room.

FIG. 1 shows the schematic structure of the disinfection device 5 according to the invention as an external auxiliary unit for a hypothermia device 1. In this case, disinfection device 5 and hypothermia device 1 are arranged outside an operating range 13, so that the disinfection device 5 does not have to meet the high hygienic requirements of the normal operating environment. This combination of disinfection device 5 and hypothermia device 1 takes place advantageously in times when the hypothermia device 1 is not needed. In principle, the disinfecting device 5 according to the invention can also be located inside a hypothermia device 1, if any emission of the disinfecting fluid 18 into the hypothermia device 1 or the surgical area 13 can be excluded.

The disinfection device 5 is fed with contaminated, coming in this example of a hypothermia device 1 water as a liquid 19 from the inlet 15. For this purpose, the water circuits 14, 15 of the hypothermia device 1, for example, with conventional fluidic connectors 12 are connected to the disinfection device 5. Ström ungsseitig before these fluidic connectors 12 are on the side of the hypothermia device 1 in each of the water circuits 14, 15 electromotive controllable valves 24, 25, which can be opened and closed individually. Between each of the water circuits 14, 15 is in each case a connecting line 26 between the water circuits 14 and 15 arranged such that when closing the valves 24, 25, a fluidic short circuit between the water circuits 14 and 15 is formed and the fluid volume does not enter the disinfection device 5, but circulated within the hypothermia device 1. This allows each individual water cycle to be treated separately with the disinfectant onseinrichtung 5 are connected or disconnected from the disinfection device 5, so that only individual water circuits of the hypothermia device 1 can be disinfected as described below, while the other water circuits of the hypothermia device 1 are normally in operation.

Within the disinfection device 5, the volume flows of the liquid 19 from the inlet 15 are supplied by means of a manifold 16 by a controllable by a control device 6 valve 7 with a motor drive M to the addition of the disinfecting fluid 18. A divided by a valve 8 volume flow of the contaminated water 19 from the hypothermia 1 by means of an injector 16, the disinfecting fluid 18 is added from the controllable device 2 for providing the disinfecting fluid 18, which mixes with the remaining part volume flow of the contaminated water 19 in the course. In the deactivation unit 3, which is then flowed through by the liquid 19, the disinfection process continues. By the reaction of the disinfecting fluid 18 with the bacteria, viruses, etc. in the liquid 19, the disinfection of the liquid 19, here the water. Depending on the existing volume flow, the contaminated water 19 from the hypothermia device 1 must pass through the disinfection device 5 or else only the deactivation unit 3 several times, so that a log3 disinfection with a disinfection degree of 99.9% is achieved. For the latter case of the repeated passage through the deactivation unit 3, a bypass line, not shown in FIG. 1, can be provided, which returns the water 19 flowing out of the outlet of the deactivation unit 3 back to the inlet of the deactivation unit 3.

After the passage of the valve 9, the disinfectant fluid 18 still present in the liquid 19 is degraded in the elimination unit 4, for example by the action of a strong UV light source 21, thereby even further disinfecting liquid 19. By means of the detection device 11, for example a suitable 0 ₃ sensor, the liquid 19 exiting the elimination unit 4 is checked for complete removal of the disinfecting fluid 18. If this is the case, then the liquid 19, which has now been disinfected and purified by the disinfecting fluid 18, flows through the valve 10 back into the hypothermia device 1. Thereafter, this process begins again. If, after passage of the elimination unit 4, residues of the disinfectant 18 in the liquid 19 are still detected by the detection device 11, the control device 6 receives a corresponding signal. Immediately closes the control device 6, the motor-operated valves 10 and 7 in the inlet and outlet of the disinfection device 5 and blocks by means of the motor-operated valve 9 and the deactivation unit 3 from. At the same time, the bypass pump 17 is turned on so as to circulate the liquid 19 to the elimination unit 4 again. Furthermore, the production or addition of the disinfection fluid 18 in the device 2 is stopped immediately. This state remains in effect until the detection device 11 no longer measures any remaining disinfecting fluid 18. Only then does the control device 6 release the valves 7, 9, 10 and thus the main circuit of the liquid 19 again. The bypass pump 17 is turned off again and the device 2 continues the production of the disinfecting fluid 18 again.

If disinfection device 5 and hypothermia device 1 are not connected to one another in terms of flow, it may be useful to continue to disinfect the liquid volume contained within disinfecting device 5 continuously or temporarily, so that no increase in germs can occur here as well. For this purpose, a connection between the lines in the region of the elimination unit 4 and the manifold 16 and at the same time the valve 10 is opened or closed by the valve 23. After flowing through the elimination unit 4, the circulating within the disinfecting device 5 water is then repeatedly supplied to the addition of the disinfecting fluid 18 and can be disinfected again by adding the disinfecting fluid 18.

Each time it is switched on and off, all essential functional units of the disinfection device 5 are checked for accuracy in the context of a self-test. Only then can the settings required for operation be made after switching on via a control panel.

When used in the medical field, the disinfection device 5 should not necessarily be used in clinical operation, ie in direct connection with the patient during an operation. Rather, an essential aspect is the Disinfection device 5, in the stand-by times, in which the working example as a hypothermia device 1 is not used intraoperatively, to enable water disinfection and water conservation of the water circuits 14, 15 of the hypothermia device 1. By efficiently and repeatedly reducing the number of bacteria in these water circuits 14, 15, the likelihood of spreading contamination of the device 1 and thus possibly of the patient due to uncontrolled microbiological growth is reduced. The preferred disinfection process should therefore be described as intermittent, water-disinfecting and water-conserving. The disinfection device 5 is fed as described with the contaminated water 19 coming from the hypothermia device 1. Up to three water circuits 14, 15 of a hypothermia device 1 can be connected to the disinfection device 5, which coordinates the volume flows via the control of the valves 7, 8, 9, 10 by means of a control device 6 such as a PLC.

In case of failure and in excess of the permissible concentration of the remaining disinfecting fluid 18, when using ozone, for example, the O ₃ concentration, by the detection device 11, the water 19 flows without disinfection mainly via a bypass circuit, not shown, because then the valves 7 and 10 are closed. This ensures undisturbed operation of the hypothermia device 1.

Normally, valve 8 is at least partially closed and the flow through the valve 8 throttled so that the water to be disinfected 19 at least partially flows through the injector 20 and thus is mixed with, for example, ozone as a disinfecting fluid 18. This resulting water-ozone mixture 19 flows through the deactivation unit 3, which is sized so that the time required for disinfection reaction time is guaranteed. Subsequently, the now disinfected water-ozone mixture 19 of the elimination unit 4 is supplied, in which by means of a UV lamp 21, the de-ozonation takes place by the decomposition of the ozone. For a better mixing can serve a not shown agitator. After leaving the elimination unit 4, compliance with the limit value (0%) of residual ozone is checked with a detection device 11, for example with an O ₃ sensor. Before the purified, ozone-free water 19 returns to the hypo Thermal device 1 flows, it can be controlled again with a second downstream arranged detection device 11 in the form of another 0 ₃ - sensor for ozone freedom. After passing through these possibly multi-stage controls within the disinfection device 5 according to the invention, the water 19 then flows back to the hypothermia device.

In addition to the controls described above within the disinfection device 5, other detection devices, e.g. a detection device for the pH of the water to be disinfected or disinfected 19 are provided so that other properties of the water 19 can be controlled continuously or temporarily.

Performance data of the disinfection device 5 according to the invention, given purely as examples, are as follows.

• Flow rate variable, min. however 5 l / min during operation and max. ^' 1 l / min in standby

• Irradiance, measured at the line 254 nm approx. 450 J / m ²

• The contact time t _{c of} the ozone with the contaminated liquid (mycobacterium chimaera) is at least t _c = 0.17, which corresponds to approx. 1 minute. To increase the mixing, an agitator can additionally be used

Ozone is added by means of a venturi injector 20, preferably of 280 mg / m ³

• Ozone production 6 l / min, concentration 0.1 to 0.4%

• Motor operated 2-way valves 7, 8, 9, 10 made of stainless steel with flanges

De-ozonation by means of a UV lamp 21 at a wavelength of 254 nm, irradiation power 300-600 J / m ² , power consumption of 3 to 30 W.

• Volume flow through the disinfection device 5 l / min

• Volume flow of the injector 4.3 l / min

• Volume flow of the disinfecting fluid 0.025 l / min

Ensuring easy replacement of all essential components. The disinfection device 5 can advantageously be used for sterilizing a variety of devices in the hospital or general health, such as in online operation on the patient, ie during surgery even in the operating room. It is also conceivable to use the disinfection device 5 in the field of dialysis machines. In general, the disinfection device 5 can also be used within a hospital for the substitution of regularly exchanged filters of all kinds, thereby saving high costs, such as to prevent or stem the constant contamination of drinking water circuits with eg Legionella.

Furthermore, it is also conceivable that the disinfection device 5 also in the field of general drinking water supply, e.g. at predestined exit points to prevent the formation of e.g. Prevent or stem legionella ..

The disinfection device 5 is also suitable for permanent disinfection of cooling systems in the pharmaceutical industry or in the food industry and for the disinfection of air conditioning systems (especially in the hospital sector).

Item number list - device hypothermia device

- Device for providing a disinfecting fluid - Deactivation unit

- elimination unit

- Disinfection device

- Control device

- Valve

- Valve

- Valve

- Valve

- Detection device / sensor

- Fluid connectors

- border surgical area

- Return fluid circuits

- Inlet fluid circuits

- Manifold

- Bypass pump

- Disinfecting fluid

- Liquid

- Injector

- UV light

- Flow direction

- Valve

- Valve

- Valve

- Fluid line

Claims

claims 1. A method for disinfecting fluid circuits (14, 15) in a device (1), in particular of water circuits (14, 15) in a hypothermia device (1). characterized in that the liquid (19) of the liquid circuit (14, 15) for disinfection at least temporarily by a disinfection device (5) is passed, which comprises means (2) for providing a disinfecting fluid (18), the disinfecting fluid (18) of the passed liquid (19) is added and the liquid (19) in a deactivation unit (3) disinfected by the disinfecting fluid (18), the disinfected liquid (19) is then passed into an elimination unit (4) for eliminating the disinfecting fluid (18) in which the disinfected liquid (19) remains or the disinfected liquid (9) passes through until the disinfecting fluid (18) is completely eliminated by the elimination unit (4) from the disinfected liquid (19), at least one Detection device (11) the degree of elimination of the disinfecting fluid (18) from the disinfected liquid (19) continuously checked, and only after determining the complete elimination of the disinfecting fluid (18), the disinfected liquid (19) back into the fluid circuit (14, 15) of the device (1) is returned. 2. The method according to claim 1, characterized in that as a disinfecting fluid (18) a residue-degradable fluid, in particular ozone is used, the microbiological burden, especially the multiplication of bacteria, fungi and algae, in the liquid to be disinfected (19) permanently inhibits. 3. The method according to claim 1, characterized in that the disinfecting fluid (18) allows a log3 disinfection of the liquid (19). 4. The method according to claim 1, characterized in that the means (2) for providing a disinfecting fluid (18) the disinfecting fluid (18) itself generates, preferably ionized air from the environment to ozone. 5. The method according to claim 1, characterized in that the disinfecting fluid (18), preferably by means of an injector (20), at least a partial volume flow of the liquid (19) of the liquid circuit (14, 15) is added. 6. The method according to claim 1, characterized in that the added disinfecting fluid (18) with the liquid (19) of the liquid circuit (14, 15) is mixed. 7. The method according to claim 1, characterized in that the deactivation unit (3) for the disinfection of the liquid (19) is dimensioned and thus flows through the liquid (19), that the liquid (19) in the flow through the deactivation unit (3) disinfected safely. 8. The method according to claim 1, characterized in that the liquid flows through the deactivation unit (3) so often until the liquid (19) is safely disinfected. 9. The method according to claim 1, characterized in that in the elimination unit (4) ultraviolet radiation (21) is used to decompose and degrade the disinfecting fluid (18), preferably the ozone, after the disinfection of the liquid (19). 10. The method according to claim 1, characterized in that the disinfected liquid (1) as long as again the elimination unit (4) is supplied until the elimination of the disinfecting fluid (18) has been completed. 11. The method according to claim 1, characterized in that at least one detection device (11) continuously determines the degree of elimination of the disinfecting fluid (18) after flowing through the elimination unit (4). 12. The method according to claim 1, characterized in that the return of the liquid (19) in the liquid circuit (14, 15) of the device (1) is released only when the at least one detection device (11) determines that the disinfecting fluid ( 18) was completely removed from the disinfected liquid (19). 13. The method according to claim 1, characterized in that the at least one detection device (11) influences the flow of the disinfected liquid (19) such that upon detection of incomplete elimination of the disinfecting fluid (18) the disinfected liquid (19) again through the Elimi- tion unit (4) is guided. 14. The method according to claim 1, characterized in that the disinfection device (5) the liquid circuit (14, 15) of the hypothermia device (1) during periods of non-use of the hypothermia device (1) continuously disinfected. 15. The method according to claim 1, characterized in that in the case of a power failure, the disinfection device (5) is placed in an operating state in which the liquid circuit (14, 15) of the device (1) flows past the disinfection device (5). 16. Disinfection device (5) for fluid circuits (14, 15) in a device (1), in particular for water circuits in a hypothermia devices, in particular for carrying out the method according to claim 1, characterized in that the fluid circuit (14, 15) of the device ( 1) the disinfection device (5) flows through at least temporarily, the disinfection device (5) has a device (2) for providing a disinfecting fluid (18) which adds the provided disinfecting fluid (18) to the liquid in a deactivation unit (3), whereby the disinfecting fluid (18) disinfecting the liquid (19), a deactivation unit (4) is arranged adjacent to the deactivation unit (3), into which the disinfected liquid (19) enters and in which the disinfecting fluid (18) is eliminated, wherein at least one detection device (11) determines the degree of elimination of the disinfecting fluid (18) continuously checked in the liquid (19) and associated with valve means (7, 8, 9, 10) such that the disinfected liquid (19) only after complete elimination again in the fluid circuit (14, 15) of the device ( 1) is returned. 17. Disinfection device (5) according to claim 16, characterized in that the disinfection device (5) only in times of non-use of the device (1), preferably of the hypothermia device (1), with the liquid (19) of the liquid circuit to be disinfected (14, 15) in liquid-conducting compound (12). 18. disinfection device (5) according to claim 16, characterized in that the device (1), preferably hypothermia device (1), and the disinfection device (5) in the implementation of the disinfection outside an operating room (13) are arranged. 19 disinfection device (5) according to claim 18, characterized in that the disinfection device (5) as an additional unit to a hypothermia device (1) connectable, preferably in the bypass between flow (15) and return (14) of the hypothermia device (1) is looped. 20. disinfection device (5) according to claim 16, characterized in that the disinfection device (5) for performing the disinfection in the device (1), preferably in the hypothermia device (1), integrated or coupled to the device (1). 21. disinfection device (5) according to claim 19, characterized in that the volume of the liquid to be disinfected (19) in the disinfection device (5) for the disinfection of a hypothermia device (1) is no longer 1 I. Disinfecting device (5) according to any one of claims 16 to 21, characterized in that the means (2) for providing a disinfection onsfluids (18) the disinfecting fluid (18) in the flow direction (22) of the liquid (19) before the deactivation unit (3 ) is arranged and, preferably by means of an injector (20), at least a partial volume flow of the liquid (19) the disinfecting fluid (18) added. Disinfecting device (5) according to claim 22, characterized in that the means (2) for providing a disinfecting fluid (18) comprises an ionizer for generating ozone (18) from ambient air. Disinfection device (5) according to any one of claims 16 to 23, characterized in that the deactivation unit (3) has a straight or helical, sufficiently long and by the liquid (19) flow-through line for the reaction of the disinfecting fluid (18) with the liquid (19) having. Disinfection device (5) according to any one of claims 16 to 24, characterized in that upstream and downstream of the deactivation unit (3) controllable valves (8, 9) are arranged and controlled and connected to lines for the liquid (19) that disinfecting liquid (19) as long through the deactivation unit (3) circulates until the liquid (19) is safely disinfected. Disinfecting device (5) according to any one of claims 16 to 25, characterized in that in the elimination unit (4) an irradiation source (21) for ultraviolet radiation is arranged, which acts on the disinfectant fluid (18) offset liquid (19) and the disinfecting fluid ( 18), preferably ozone, after the disinfection of the liquid (19) decomposes and degrades. Disinfecting device (5) according to any one of claims 16 to 26, characterized in that upstream and downstream of the elimination unit (4) controllable valves (9, 10) are arranged and controlled and connected to lines for the liquid (19) that the disinfected Liquid (19) for so long through the elimination unit (4) until the disinfecting fluid (18) is completely degraded in the disinfected liquid (19). Disinfecting device (5) according to one of claims 16 to 27, characterized in that the at least one detection device (11) is arranged so that the detection device (11) determines the degree of elimination of the disinfecting fluid (18) after flowing through the elimination unit (4). certainly. Disinfecting device (5) according to any one of claims 16 to 28, characterized in that at least one further detection device (11) is arranged so that the degree of elimination of the disinfecting fluid (18) before returning the liquid (19) into the fluid circuit (14 , 15) of the device (1) is determined. Disinfection device (5) according to any one of claims 16 to 29, characterized in that the valves (7, 8, 9, 10) of the disinfection device (5) adjustable by motor and by a control device (6), preferably a programmable logic controller (6), can be influenced automatically. Disinfecting device (5) according to one of claims 16 to 30, characterized in that the control device (6) with the means (2) for providing a disinfecting fluid (18), the deactivation unit (3), the elimination unit (4), the at least one Detektionsseignchtung (11), pumps (17) and motor-operated valves (7, 8, 9, 10) is connected by signal technology and controls the operation of the disinfection device (5). Disinfecting device (5) according to one of claims 16 to 31, characterized in that the lines and other devices of the disinfecting device (5), which come into contact with the liquid to be disinfected (19), are resistant to the disinfecting fluid (18).