Otteni J C, Ancellin J, Cazalaà J B, Clergue F
Service d'Anesthésie-Réanimation Chirurgicale, CHU de Hautepierre, Strasbourg.
Ann Fr Anesth Reanim. 1994;13(5):713-25. doi: 10.1016/s0750-7658(05)80729-4.
The anaesthetic machine, the recovery room or the ICU ventilator as well as any other simple oxygenation device can be accidentally supplied with a "wrong" gas, or a mixture of "wrong" and "true" gases, or a gas containing chemical impurities, as a result of one of the following causes: a) the source of the medical gas pipeline supply contains a "wrong" gas or impurities; b) the gas pipeline is polluted by a "wrong" gas or solvents, introduced during the installation or maintenance of the pipeline; c) the pipeline is polluted by a wrong gas at a point of inter-connection or cross-connection of two pipelines; d) supply of a "wrong" gas through wrong quick couplers connected to the pipeline; e) back flow of a gas in another pipeline supply through a defective gas mixer, which is today the most common cause of pipeline contamination or retropollution. It occurs with some types of mixers in case of absence or malfunction of non-return valves, associated with a pressure difference between the two gas lines. The means of prevention, recognition and emergency treatment of these events include: a) systematic removal of mixers and flowmeter-mixers from supplies when not in use; b) periodical checking of these devices for an accidental communication between the gases to be mixed; c) systematic use of an oxygen analyser for a continuous measurement of FIO2, especially when the machine is connected to the N2O pipeline supply; d) the presence of a reserve cylinder of oxygen connected to every anaesthetic machine.
麻醉机、恢复室或重症监护病房的呼吸机以及任何其他简单的氧合设备，可能会因以下原因之一而意外供应“错误”的气体，或“错误”与“正确”气体的混合物，或含有化学杂质的气体：a）医用气体管道供应源包含“错误”的气体或杂质；b）气体管道在安装或维护期间被引入的“错误”气体或溶剂污染；c）在两条管道的互连或交叉连接点处管道被错误的气体污染；d）通过连接到管道的错误快速接头供应“错误”的气体；e）气体通过有缺陷的气体混合器在另一个管道供应中回流，这是目前管道污染或反向污染最常见的原因。在止回阀缺失或故障且两条气体管路之间存在压差的情况下，某些类型的混合器会出现这种情况。这些事件的预防、识别和应急处理方法包括：a）在不使用时系统地从供应中移除混合器和流量计 - 混合器；b）定期检查这些设备，以防待混合气体之间意外连通；c）系统地使用氧分析仪连续测量FIO2，特别是当机器连接到N2O管道供应时；d）每台麻醉机都连接一个备用氧气瓶。
