de la Fuente-Sancho I, Romeu-Bordas Ó, Fernández-Aedo I, Vallejo De la Hoz G, Ballesteros-Peña S
Organización Sanitaria Integrada de Bilbao-Basurto, Bilbao, Bizkaia, España.
Universidad del País Vasco/Euskal Herriko Unibertsitatea, Leioa, Bizkaia, España.
Med Intensiva (Engl Ed). 2019 Jan-Feb;43(1):18-25. doi: 10.1016/j.medin.2017.11.003. Epub 2017 Dec 17.
To determine the risk of microbiological contamination with hospital use high- and low-flow bubbling humidifiers.
A systematic literature review was carried out in 6 databases. Observational or experimental studies published between 1990 and 2016 were selected, written in English or Spanish, and in which microbiological contamination with hospital use high- and low-flow bubbling humidifiers was investigated.
A total of 12 articles were included: 4 analyzed the water from reusable humidifiers, 4 analyzed the water from prefilled system humidifiers, and the rest compared samples from both models. Microbial contamination was observed in all studies in which reusable humidifiers were evaluated, usually involving common bacteria from the skin flora, while potential pathogenic species were notified in 2 studies. No microbial contamination was isolated from reusable humidifiers, regardless of whether they had been consecutively used over time by a single patient or by several patients.
On one hand, there seems to be a low risk of contamination during the first weeks of use of prefilled humidifiers, which allows multiple use in different patients, without a risk of cross-contamination. On the other hand, it should be underscored that handling reusable humidifiers without correct aseptic measures can increase the risk of contamination; replacing reusable humidifiers with prefilled models therefore could be the safest option.
确定医院使用的高流量和低流量气泡式加湿器的微生物污染风险。
在6个数据库中进行了系统的文献综述。选取1990年至2016年间发表的观察性或实验性研究，这些研究以英文或西班牙文撰写，且对医院使用的高流量和低流量气泡式加湿器的微生物污染情况进行了调查。
共纳入12篇文章：4篇分析了可重复使用加湿器中的水，4篇分析了预充式系统加湿器中的水，其余文章对两种型号的样本进行了比较。在所有评估可重复使用加湿器的研究中均观察到微生物污染，通常涉及皮肤菌群中的常见细菌，而在2项研究中报告了潜在的致病菌种。无论可重复使用加湿器是由单个患者还是多个患者连续使用一段时间，均未从其中分离出微生物污染。
一方面，预充式加湿器在使用的最初几周似乎污染风险较低，这使得其可在不同患者中多次使用，而不存在交叉污染风险。另一方面，应强调的是，在没有正确无菌措施的情况下处理可重复使用加湿器会增加污染风险；因此，用预充式型号取代可重复使用加湿器可能是最安全的选择。
