Cork University Hospital
Renal Dialysis Cork University Hospital (CUH) is the major acute hospital in the South of Ireland. In October 2010, a new Cardiac Renal Centre was opened on the CUH campus. This was a separate new building project on campus at a cost of €85M fully integrated into the existing hospital. The renal dialysis unit in the centre which is now the largest in Ireland comprises 71 stations, with one of its aims to allow dialysis patients the flexibility of treatment at more sociable times with the most up to date equipment.
With dialysis facilities based over 3 floors, the challenge was to design a system that would avoid long distribution pipe runs to the patient points. To facilitate this requirement, it was decided that each floor should have its own dedicated loop with its own individual RO. Two of the RO plants are served by a common pretreatment system with all of the items duplexed for security of supply. The third RO plant had its own individual pretreatment, as it was being relocated from a temporary facility within the hospital, where it had replaced an older system.
Three new ringmain distribution loops were installed, each linked to a Double Pass RO, which is fully disinfectable at 85°C, and this applies not only to the RO, as the ring main loops are also disinfectable with 85°C hot water.
As is Whitewater’s normal design for dialysis water plants (but unique in other dialysis water supply systems) we installed our ‘double hose connection system’. This system recirculates water right up to the dialysis machine, avoiding the deadleg (2 metres) of the standard single connection hose. The benefits of this connection system are that even when the dialysis machine is disconnected from the system, recirculation is still taking place through the double hose and will also be heat disinfected when the loop is being disinfected. Heat disinfection of the RO itself and the ringmain loop to 85°C, all combine to produce Ultrapure Water to the Renal Association Guidelines set at 0.1 cfu/ml TVC and 0.03 EU/ml endotoxin.
Where the dialysis pure water supply can be guaranteed to the Ultrapure Water guidelines, this will support the use of the preferred mode in dialysis treatment, on line haemodiafiltration (OLHDF). This significantly increases benefits for patient well being. Patients have more energy, sleep better and feel much better after a period of weeks of OLHDF treatment.
All three plants have now been validated for over 3 years to the Renal Association guidelines for Dialysis Ultrapure Water.