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本文引用的文献

1
Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1.与严重急性呼吸综合征冠状病毒1(SARS-CoV-1)相比,严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在气溶胶和表面的稳定性
N Engl J Med. 2020 Apr 16;382(16):1564-1567. doi: 10.1056/NEJMc2004973. Epub 2020 Mar 17.
2
Different Types of Heater-Cooler Units and Their Risk of Transmission of Mycobacterium chimaera During Open-Heart Surgery: Clues From Device Design.不同类型的热交换器及其在心脏直视手术中传播耻垢分枝杆菌的风险:来自设备设计的线索。
Infect Control Hosp Epidemiol. 2018 Jul;39(7):834-840. doi: 10.1017/ice.2018.102. Epub 2018 May 28.
3
infections in post-operative patients exposed to heater-cooler devices: An overview.暴露于变温水箱设备的术后患者感染:综述
Can Commun Dis Rep. 2017 May 4;43(5):107-113. doi: 10.14745/ccdr.v43i05a05.
4
A Cost-Benefit Analysis of Reducing Surgical Site Infections.降低手术部位感染的成本效益分析
Am Surg. 2018 Feb 1;84(2):254-261.
5
Traffic flow and microbial air contamination in operating rooms at a major teaching hospital in Ghana.加纳一家主要教学医院手术室的交通流量和微生物空气污染。
J Hosp Infect. 2018 Jul;99(3):263-270. doi: 10.1016/j.jhin.2017.12.010. Epub 2017 Dec 16.
6
Operating Room Traffic Increases Aerosolized Particles and Compromises the Air Quality: A Simulated Study.手术室人流量增加气溶胶粒子并降低空气质量:模拟研究。
J Arthroplasty. 2018 Mar;33(3):851-855. doi: 10.1016/j.arth.2017.10.012. Epub 2017 Oct 16.
7
Nontuberculous Mycobacterium Infections Associated With Heater-Cooler Devices.与热交换器设备相关的非结核分枝杆菌感染
Ann Thorac Surg. 2017 Oct;104(4):1237-1242. doi: 10.1016/j.athoracsur.2017.04.067. Epub 2017 Aug 16.
8
Does laminar airflow make a difference to the infection rates for lower limb arthroplasty: a study using the National Joint Registry and local surgical site infection data for two hospitals with and without laminar airflow.层流空气对下肢关节置换术的感染率有影响吗:一项利用国家关节注册中心以及两家有和没有层流空气的医院的局部手术部位感染数据进行的研究。
Eur J Orthop Surg Traumatol. 2017 Feb;27(2):261-265. doi: 10.1007/s00590-016-1852-1. Epub 2016 Sep 29.
9
Forced-air warming design: evaluation of intake filtration, internal microbial buildup, and airborne-contamination emissions.强制空气加热设计:进气过滤、内部微生物积聚及空气传播污染物排放的评估
AANA J. 2013 Aug;81(4):275-80.
10
Traffic flow in the operating room: an explorative and descriptive study on air quality during orthopedic trauma implant surgery.手术室中的交通流量:骨科创伤植入手术期间空气质量的探索性和描述性研究。
Am J Infect Control. 2012 Oct;40(8):750-5. doi: 10.1016/j.ajic.2011.09.015. Epub 2012 Jan 29.

一种识别设备如何扰乱手术室气流模式的新方法。

A Novel Approach to Identifying How Equipment Disrupts the Airflow Patterns in the Operating Room.

机构信息

Hartford Hospital, Heart and Vascular Institute, Hartford, Connecticut.

出版信息

J Extra Corpor Technol. 2021 Jun;53(2):130-136. doi: 10.1182/ject-2100019.

DOI:10.1182/ject-2100019
PMID:34194079
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8220907/
Abstract

A decrease in the infection rates in the operating room (OR) is attributable to advances in sterile technique; heating, ventilation, and air-conditioning (HVAC) filtration; and limiting the number of people entering and leaving the OR. However, some infection complications after open heart procedures have been linked to the discharge fans of surgical equipment, most notably from the LivaNova 3T. We believe that surgical infection within the OR may also be due to other devices with internal fans. The purpose of this study was to 1) identify surgical equipment with an internal fan and see how they affect the airflow in an OR, 2) use the equipment to positively affect airflow to possibly reduce the risk of surgical site infections, and 3) bring attention to the HVAC system ability to exchange air throughout the OR. By using a fog machine and multiple camera angles, we identified the devices that have an effect on the airflow. We saw that the direction of the intake vent of specific devices can change the direction of airflow and possibly help to remove air. Last, we showed how the current HVAC air exchange rate might not be enough to remove contaminated air within the OR. Understanding intake and discharge vents for all equipment is important because sterile contamination and wound infection may be minimized or mitigated completely by simply repositioning a few devices.

摘要

手术室(OR)感染率的降低归因于无菌技术的进步、加热、通风和空调(HVAC)过滤以及限制进出 OR 的人数。然而,一些心脏直视手术后的感染并发症与手术设备的排气扇有关,尤其是来自 LivaNova 3T 的排气扇。我们认为,手术室内部的手术感染也可能是由于其他带有内部风扇的设备引起的。本研究的目的是:1)确定带有内部风扇的手术设备,观察它们如何影响 OR 中的气流;2)使用设备对气流产生积极影响,以降低手术部位感染的风险;3)引起人们对 HVAC 系统在整个 OR 中交换空气的能力的关注。通过使用雾机和多个摄像头角度,我们确定了对气流有影响的设备。我们发现,特定设备的进风口方向可以改变气流方向,并可能有助于排出空气。最后,我们展示了当前的 HVAC 空气交换率可能不足以清除 OR 内的污染空气。了解所有设备的进风口和排风口非常重要,因为通过简单地重新定位几个设备,就可以将无菌污染和伤口感染降到最低或完全消除。