Neft M W, Goodman J R, Hlavnicka J P, Veit B C
Madigan Army Medical Center, Tacoma, Wash., USA.
AANA J. 1999 Oct;67(5):433-9.
Heat and moisture exchangers (HMEs) have been used for more than 30 years for heat and moisture retention during general anesthesia. Studies about bacteriostatic vs nonbacteriostatic HMEs (BHMEs/NHMEs) have been conducted to assess their role in preventing bacterial transmission to the anesthesia breathing circuit; none have been done on anesthetized patients in the operating room. The present study adds to existing knowledge about the HME's ability to prevent transmission of bacteria, with implications for cost reduction resulting from reuse of anesthesia breathing circuits among patients. The chi 2 test revealed no statistically significant differences between groups in transmission of bacteria from endotracheal tube (ETT) to anesthesia breathing circuit (P = .48). However, both groups showed statistically significant differences between presence of bacteria in ETTs and anesthesia breathing circuits: Group 1, BHME (P < .005) and group 2, NHME (P < .005). Neither HME prevented contamination of the machine side of the circuit. These results support not reusing breathing circuits. Of 53 participants in group 2, 28 had positive ETT cultures with 7 showing transmission to anesthesia breathing circuit. Of 46 participants in group 1, 28 had positive ETT cultures with 9 showing transmission to anesthesia breathing circuit.
热湿交换器（HMEs）已用于全身麻醉期间的热量和水分保持30多年。关于抑菌型与非抑菌型热湿交换器（BHMEs/NHMEs）的研究已经开展，以评估它们在防止细菌传播至麻醉呼吸回路中的作用；但尚未在手术室的麻醉患者身上进行过此类研究。本研究增加了关于热湿交换器防止细菌传播能力的现有知识，对因在患者间重复使用麻醉呼吸回路而降低成本具有启示意义。卡方检验显示，两组在细菌从气管内导管（ETT）传播至麻醉呼吸回路方面无统计学显著差异（P = 0.48）。然而，两组在ETT和麻醉呼吸回路中细菌的存在情况之间均显示出统计学显著差异：第1组，BHME（P < 0.005）和第2组，NHME（P < 0.005）。两种热湿交换器均未防止回路机器端受到污染。这些结果支持不重复使用呼吸回路。在第2组的53名参与者中，28名ETT培养呈阳性，其中7名显示细菌传播至麻醉呼吸回路。在第1组的46名参与者中，28名ETT培养呈阳性，其中9名显示细菌传播至麻醉呼吸回路。
