Cameron J L, Reese W A, Tayal V S, Clark R F, Kelso D, Gonzalez E R, Garnett A R, Ornato J P
Ann Emerg Med. 1986 Nov;15(11):1300-2. doi: 10.1016/s0196-0644(86)80614-x.
The risk and benefit of oxygen humidification during ambulance transport is unknown. We cultured the water in plastic multiple-use bottles of humidifiers on 30 randomly selected area ambulances during November 1985. There were 22 positive cultures. Potentially pathogenic bacteria (four Pseudomonas maltophilia, three Pseudomonas aeruginosa, one Klebsiella pneumoniae, and one Staphylococcus epidermidis) were found in nine samples. Assuming that the water in ambulance humidifiers should have been sterile, the findings are statistically significant (P less than .01). Because there is no evidence that humidification is of benefit for nonintubated patients receiving oxygen at flow rates of 4 L/min or less when environmental humidity is adequate, we suggest that such patients should receive oxygen without humidification during ambulance transport. All other patients requiring oxygen during ambulance transport should continue to receive humidified oxygen. If a multiple-use humidifier reservoir is to be used, a written policy for its use must be developed and there must be appropriate documentation of compliance with the policy. An alternative is to replace the multiple-use humidifier reservoir with single-use sterile disposable devices, which cost approximately $2.00 per unit.
在救护车转运过程中进行氧气湿化的风险和益处尚不清楚。1985年11月，我们在30辆随机选取的地区救护车上，对加湿器的塑料多用途瓶中的水进行了培养。有22份培养结果呈阳性。在9份样本中发现了潜在的病原菌（4株嗜麦芽窄食单胞菌、3株铜绿假单胞菌、1株肺炎克雷伯菌和1株表皮葡萄球菌）。假设救护车加湿器中的水本应无菌，这些发现具有统计学意义（P小于0.01）。由于没有证据表明当环境湿度适宜时，对于以4升/分钟或更低流速吸氧的非插管患者，湿化有益，我们建议此类患者在救护车转运期间应接受无湿化的氧气。所有其他在救护车转运期间需要吸氧的患者应继续接受湿化氧气。如果要使用多用途加湿器储水器，必须制定关于其使用的书面政策，并且必须有遵守该政策的适当记录。另一种选择是以一次性无菌一次性装置替代多用途加湿器储水器，每个装置成本约为2.00美元。
