Berg P W, Stuttmann R, Doehn M
Abteilung für Anaesthesiologie, Kliniken der Stadt Köln, Krankenhaus Merheim.
Anaesthesist. 1997 Oct;46(10):856-9. doi: 10.1007/s001010050479.
Today, noise pollution is an evident and ubiquitous problem even in intensive care units. Noise can disturb the physiological and psychological balance in patients and staff. Especially intubated patients and those breathing spontaneously through a T-piece are exposed to the noise emitted by the nebuliser used to humidity the respiratory gas. This may make patients feel uncomfortable. To reduce noise pollution in the ICU a modified T-piece has been developed and investigated. In order to heat and humidity the respiratory gas a Conchaterm III unit (Kendall company) and a thermo flow cylinder (De Vilbiss company) is necessary. While respiratory gas is flowing, water is sucked out of the heated thermoflow cylinder and nebulised according to the Venturi-Bernoulli principle. To adjust the oxygen concentration of the respiratory gas a plastic ring must be turned to either close (98% oxygen) or open a valve allowing room air to mix (40% oxygen). Noise pollution of the unit varies with admixture of room air. With a new device--a special oxygen-air mixing chamber--the oxygen concentration of the respiratory gas can be adjusted outside the thermoflow cylinder, hardly producing any noise pollution. Therefore the principle of nebulisation could be changed to humidification. A thermoflow cylinder without the nebulisation unit allows the respiratory gas to flow through the thermoflow cylinder over heated and evaporating water, hardly causing any noise pollution. In both types of T-pieces the temperature of the respiratory gas is controlled and corrected by the Conchaterm unit. As the result of these modifications, noise pollution has been reduced from 70 dB(A) to 55 dB(A). In the modified T-piece, the quality of humidification has been evaluated with a fresh gas flow of 22 l/min and at a gas temperature of 37 degrees C, not only collecting condensed water but also lost water. The modified T-piece allows a physiological humidification of the respiratory gas. The modified T-piece is a simple and efficacious substitute. Patients and staff are protected from adverse noise effects and patient well-being might be improved.
如今，即使在重症监护病房，噪音污染也是一个明显且普遍存在的问题。噪音会干扰患者和医护人员的生理及心理平衡。特别是插管患者以及那些通过T形管自主呼吸的患者，会暴露于用于湿润呼吸气体的雾化器所发出的噪音中。这可能会让患者感到不适。为了减少重症监护病房的噪音污染，已研发并研究了一种改良的T形管。为了加热和湿润呼吸气体，需要一个Conchaterm III装置（肯德尔公司）和一个热流筒（德维比斯公司）。当呼吸气体流动时，水从加热的热流筒中吸出，并根据文丘里 - 伯努利原理进行雾化。为了调节呼吸气体的氧气浓度，必须转动一个塑料环以关闭（98%氧气）或打开一个允许室内空气混合的阀门（40%氧气）。该装置的噪音污染会随着室内空气的混合而变化。使用一种新装置——一个特殊的氧气 - 空气混合腔——呼吸气体的氧气浓度可以在热流筒外部进行调节，几乎不会产生任何噪音污染。因此，雾化原理可以改为加湿。一个没有雾化装置的热流筒允许呼吸气体流过加热并蒸发水的热流筒，几乎不会造成任何噪音污染。在这两种类型的T形管中，呼吸气体的温度由Conchaterm装置控制和校正。这些改进的结果是，噪音污染已从70分贝(A)降至55分贝(A)。在改良的T形管中，在新鲜气体流量为22升/分钟且气体温度为37摄氏度的情况下，对加湿质量进行了评估，不仅收集了冷凝水，还收集了散失的水。改良的T形管能够对呼吸气体进行生理性加湿。改良的T形管是一种简单且有效的替代品。患者和医护人员免受有害噪音影响，患者的舒适度可能会得到提高。
