Kacmarek R M, Kratohvil J
Massachusetts General Hospital, Boston 02114.
Respir Care. 1992 Jan;37(1):37-45.
Because of our concern for the safety of bedside caregivers who care for infants receiving ribavirin for long periods of time each day for many days, we evaluated the effectiveness of a double-tent enclosure with vacuum scavengers during simulated and actual patient administration.
MATERIALS & METHODS: Part 1--We sought to determine whether two or three scavenging pumps were necessary, by 3 8-h trials with 2 pumps and 3 8-h trials with 3 pumps. Entry into and replacement of mannequin occurred according to protocol. Continuous samples were obtained from three locations in the room. Part 2--The double-tent, double-pump scavenger system was evaluated with patient simulation for a 16-h period. Part 3--The double-tent, double-pump system was evaluated during actual patient use. Air samples were also collected during ribavirin administration via mechanical ventilator circuit with filters in the expiratory limb. Coded environmental samples were analyzed by liquid chromatography.
Environmental levels were effectively decreased below published maximal acceptable levels.
Use of a double-enclosure, double-pump scavenging system and implementation of entry protocols ensure reduction of environmental ribavirin levels below recommended maximum levels during administration to spontaneously breathing patients. Use of expiratory filters adequately controls environmental ribavirin levels during mechanical ventilation.
由于我们担心床边护理人员的安全，这些护理人员每天要长时间护理接受利巴韦林治疗的婴儿，持续多日，因此我们在模拟给药和实际患者给药过程中评估了带有真空清除装置的双层帐篷隔离罩的有效性。
第1部分——我们通过使用2个泵进行3次8小时试验和使用3个泵进行3次8小时试验，试图确定是否需要两个或三个清除泵。根据方案对人体模型进行放置和更换。从房间的三个位置持续采集样本。第2部分——使用患者模拟对双层帐篷、双泵清除系统进行了16小时的评估。第3部分——在实际患者使用期间对双层帐篷、双泵系统进行了评估。在通过呼气支路带有过滤器的机械通气回路给予利巴韦林期间也采集了空气样本。对编码的环境样本进行液相色谱分析。
环境水平有效降低至公布的最大可接受水平以下。
使用双层隔离罩、双泵清除系统并实施进入方案可确保在对自主呼吸患者给药期间将环境中利巴韦林水平降低至推荐的最大水平以下。在机械通气期间使用呼气过滤器可充分控制环境中利巴韦林水平。
