Emergency Medicine and Internal Medicine, SUNY Downstate and Kings County Hospital Center, Brooklyn, New York, USA
Emergency Medicine, SUNY Downstate and Kings County Hospital Center, Brooklyn, New York, USA.
Emerg Med J. 2021 Mar;38(3):220-223. doi: 10.1136/emermed-2020-209972. Epub 2020 Dec 4.
Disasters have the potential to cause critical shortages of life-saving equipment. It has been postulated that during patient surge, multiple individuals could be maintained on a single ventilator. This was supported by a previous trial that showed one ventilator could support four sheep. The goal of our study is to investigate if cross contamination of pathological agents occurs between individuals on a shared ventilator with strategically placed antimicrobial filters.
A multipatient ventilator circuit was assembled using four sterile, parallel standard tubing circuits attached to four 2 L anaesthesia bags, each representing a simulated patient. Each 'patient' was attached to a Heat and Moisture Exchange filter. An additional bacterial/viral filter was attached to each expiratory limb. 'Patient-Lung' number 1 was inoculated with an isolate of and the circuit was run for 24 hours. Each 'lung' and three points in the expiratory limb tubing were washed with broth and cultured. All cultures were incubated for 48 hours with subcultures performed at 24 hours.
Washed cultures of patient 2, 3 and 4 failed to demonstrate growth of . Cultures of the distal expiratory tubing, expiratory limb connector and expiratory limb prefilter tubing yielded no growth of at 24 or 48 hours.
Based on this circuit configuration, it is plausible to maintain four individuals on a single ventilator for 24 hours without fear of cross contamination.
灾难有可能导致救生设备严重短缺。有人推测，在患者激增期间，一台呼吸机可以同时维持多名患者的生命。这一假设得到了之前一项试验的支持，该试验表明一台呼吸机可以支持四只绵羊。我们的研究目的是调查在共享呼吸机上放置策略性位置的抗菌过滤器时，个体之间是否会发生病理剂的交叉污染。
使用四个无菌、平行的标准管腔回路连接到四个 2 升麻醉袋，每个代表一个模拟患者，组装了多患者呼吸机回路。每个“患者”都连接到一个热湿交换过滤器。每个呼气肢上都附加了一个细菌/病毒过滤器。“患者-肺”1 号被接种了一株 ，并运行了 24 小时。用肉汤冲洗每个“肺”和呼气肢管腔的三个点，并进行培养。所有培养物在 48 小时内孵育，在 24 小时进行传代培养。
患者 2、3 和 4 的洗涤培养物未能显示 的生长。在 24 或 48 小时时，远端呼气管腔、呼气肢连接器和呼气肢预过滤器管腔的培养物均未生长 。
根据这种回路配置，可以在不担心交叉污染的情况下，在一台呼吸机上维持四名患者 24 小时。
