Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
Anesth Analg. 2011 Dec;113(6):1416-21. doi: 10.1213/ANE.0b013e318230b3cc. Epub 2011 Sep 29.
Warm air released by forced-air covers could theoretically disturb laminar airflow in operating rooms. We thus tested the hypothesis that laminar flow performance remains well within rigorous and objective standards during forced-air warming.
We evaluated air quality in 2 laminar flow operating rooms using a volunteer "patient" and heated manikin "surgeons." Reduction in tracer background particle counts near the site of a putative surgical incision was evaluated as specified by the rigorous DIN 1946-4:2008-12 standard. Results were confirmed using smoke as a visual tracer.
Background tracer particle concentrations were reduced 4 to 5 log by the laminar flow system, and there were no statistically significant or clinically important differences with a forced-air blower set to off, ambient air, and high temperature. All values remained well within the requirements of the DIN 1946-4:2008-12 standard. Activation of a forced-air warming system did not create an upward draft or interfere with normal and effective function of the laminar flow process.
Our results, based on quantitative performance testing methods, indicate that forced-air warming does not reduce operating room air quality during laminar flow ventilation. Because there is no decrement in laminar flow performance, forced-air warming remains an appropriate intraoperative warming method when laminar flow is used.
强制空气覆盖释放的暖空气理论上可能会干扰手术室层流空气的流动。因此，我们测试了以下假设，即在强制空气加热期间，层流性能仍然符合严格和客观的标准。
我们使用志愿者“患者”和加热的“外科医生”假人评估了 2 间层流手术室的空气质量。按照严格的 DIN 1946-4:2008-12 标准的规定，评估了假定手术切口部位示踪背景粒子计数的减少情况。使用烟雾作为视觉示踪剂进行了结果确认。
层流系统将背景示踪粒子浓度降低了 4 到 5 个对数级，并且与强制空气鼓风机设置为关闭、环境空气和高温时相比，没有统计学意义上的显著差异或临床意义上的重要差异。所有值均远在 DIN 1946-4:2008-12 标准的要求范围内。强制空气加热系统的激活并未产生向上的气流，也未干扰层流过程的正常和有效功能。
我们的结果基于定量性能测试方法，表明在层流通风期间，强制空气加热不会降低手术室空气质量。由于层流性能没有降低，因此在使用层流时，强制空气加热仍然是一种合适的术中加热方法。
