Berry A J, Nolte F S
Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia.
Anesth Analg. 1991 May;72(5):651-5. doi: 10.1213/00000539-199105000-00014.
Contaminated breathing systems have been responsible for nosocomial upper respiratory tract and pulmonary infections in patients undergoing general anesthesia. The current infection control guidelines for anesthesia breathing circuits require single-patient use or high-level disinfection of breathing tubes, y-connector, and reservoir bag. An alternative infection control strategy has been suggested that incorporates placement of a microbial filter downstream from the y-connector between the circuit and the patient. This laboratory study assessed the capacity of the Pall HME Filter as a bidirectional barrier to transmission of bacteria between the y-connector of an anesthesia circle breathing system and a test lung. The investigators modified a sterile circle system to allow aerosolization of a suspension of 10(9) Micrococcus luteus over 5 h into the inspiratory limb proximal to the y-connector or downstream from the filter into the test lung. Cultures indicated that the Pall HME Filter placed between the y-connector and the test lung completely prevented transmission of bacteria in both directions. The results of this study suggest that the Pall HME Filter could be used as an effective microbial barrier between the anesthesia circle breathing system and the patient as part of an alternative strategy for infection control.
受污染的呼吸系统一直是全身麻醉患者医院获得性上呼吸道和肺部感染的原因。当前麻醉呼吸回路的感染控制指南要求呼吸管、Y形接头和贮气囊单人使用或进行高水平消毒。有人提出了一种替代的感染控制策略，即在回路与患者之间的Y形接头下游放置一个微生物过滤器。这项实验室研究评估了颇尔热湿交换过滤器（Pall HME Filter）作为麻醉环路呼吸系统Y形接头与测试肺之间细菌传播双向屏障的能力。研究人员对一个无菌环路系统进行了改造，使其能够在5小时内将10⁹ 藤黄微球菌的悬浮液雾化到Y形接头近端的吸气支或过滤器下游进入测试肺。培养结果表明，置于Y形接头与测试肺之间的颇尔热湿交换过滤器完全阻止了两个方向的细菌传播。这项研究的结果表明，颇尔热湿交换过滤器可作为麻醉环路呼吸系统与患者之间有效的微生物屏障，作为感染控制替代策略的一部分。
