Kramer Axel, Kranabetter Rainer, Rathgeber Jörg, Züchner Klaus, Assadian Ojan, Daeschlein Georg, Hübner Nils-Olaf, Dietlein Edeltrut, Exner Martin, Gründling Matthias, Lehmann Christian, Wendt Michael, Graf Bernhard Martin, Holst Dietmar, Jatzwauk Lutz, Puhlmann Birgit, Welte Thomas, Wilkes Antony R
Institute for Hygiene and Environmental Medicine, University Greifswald, Germany.
GMS Krankenhhyg Interdiszip. 2010 Sep 21;5(2):Doc13. doi: 10.3205/dgkh000156.
An interdisciplinary working group from the German Society of Hospital Hygiene (DGKH) and the German Society for Anaesthesiology and Intensive Care (DGAI) worked out the following recommendations for infection prevention during anaesthesia by using breathing system filters (BSF). The BSF shall be changed after each patient. The filter retention efficiency for airborne particles is recommended to be >99% (II). The retention performance of BSF for liquids is recommended to be at pressures of at least 60 hPa (=60 mbar) or 20 hPa above the selected maximum ventilation pressure in the anaesthetic system. The anaesthesia breathing system may be used for a period of up to 7 days provided that the functional requirements of the system remain unchanged and the manufacturer states this in the instructions for use.THE BREATHING SYSTEM AND THE MANUAL VENTILATION BAG ARE CHANGED IMMEDIATELY AFTER THE RESPECTIVE ANAESTHESIA IF THE FOLLOWING SITUATION HAS OCCURRED OR IT IS SUSPECTED TO HAVE OCCURRED: Notifiable infectious disease involving the risk of transmission via the breathing system and the manual bag, e.g. tuberculosis, acute viral hepatitis, measles, influenza virus, infection and/or colonisation with a multi-resistant pathogen or upper or lower respiratory tract infections. In case of visible contamination e.g. by blood or in case of defect, it is required that the BSF and also the anaesthesia breathing system is changed and the breathing gas conducting parts of the anaesthesia ventilator are hygienically reprocessed.Observing of the appropriate hand disinfection is very important. All surfaces of the anaesthesia equipment exposed to hand contact must be disinfected after each case.
德国医院卫生协会(DGKH)和德国麻醉与重症监护学会(DGAI)的一个跨学科工作小组制定了以下关于使用呼吸过滤器(BSF)预防麻醉期间感染的建议。每个患者使用后应更换BSF。建议空气传播颗粒的过滤器截留效率>99%(II级)。建议BSF对液体的截留性能在至少60 hPa(=60 mbar)的压力下,或高于麻醉系统选定最大通气压力20 hPa时保持。只要系统功能要求不变且制造商在使用说明书中说明,麻醉呼吸系统可使用长达7天。如果发生以下情况或怀疑发生以下情况,麻醉结束后应立即更换呼吸系统和手动通气袋:涉及通过呼吸系统和手动袋传播风险的应通报传染病,如结核病、急性病毒性肝炎、麻疹、流感病毒、多重耐药病原体感染和/或定植,或上、下呼吸道感染。如果有可见污染,如被血液污染或出现故障,要求更换BSF以及麻醉呼吸系统,并对麻醉呼吸机的呼吸气体传导部件进行卫生再处理。进行适当的手部消毒非常重要。每例麻醉后,必须对麻醉设备所有暴露于手部接触的表面进行消毒。