[Prevention of contamination with a heat-and-moisture-exchanger (HME) and bacterial filter during clinical anesthesia].

Although the use of HME and bacterial filter is a common practice to protect the anesthesia machine as well as the patients from bacterial contaminants, there is no report demonstrating the effectiveness of this filter in clinical anesthesia setting. We evaluated the actual effectiveness of the filter during clinical use. While the anesthesia breathing circuit, two bacterial filters (BB 50 T, Nihon PALL) and anesthesia bag, which were sterilized with ethylen oxide gas (EOG), were connected to the anesthesia machine and used continuously for one week, EOG sterilized HME and bacterial filter (BB 25 A, Nihon PALL) were changed before each anesthesia. Culture samples were taken from the BB 25 A, the breathing circuit and the machine side of the BB 50 T. Of the 117 BB 25 A samples taken, 6 were positive for Micrococcus, alpha-Streptococcus, Bacillus, and Staphylococcus epidermidis. From 21 breathing circuit "internal" samples, one was positive for Bacillus, Staphylococcus epidermidis. But the contamination from outside sources was suspected, since all the BB 25 as used with this circuit were negative. Use of BB 25 A prevents contamination of the breathing circuit for a period of one week. If we use BB 25 A in every anesthesia case, the changing of the breathing circuit is unnecessary, reducing the cost and simplifying procedures during clinical practice.