[Prevention of cross contamination, patient to anesthesia apparatus to patient, using filters].
Concern for cross infections from patient to patient via apparatus is particularly relevant today. There are several ways to prevent patient contamination through anesthetic devices. Although there is no clinical evidence for using one alternative over another and each hospital establishes its own hygienic protocols, we have introduced the systematic use of filters with patients undergoing general anesthesia. We describe the features of filters available on the market and our protocol for their use. The efficacy of a filter depends on whether bacteria or viruses are to be controlled. Filters can be classified into three groups or generations based on mesh quality: 1) heat and humidity exchangers (HHE), with large mesh screens that allow water to pass through; 2) bacterial filters (FHHE), with finer mesh that is permeable to droplets of water and 3) folded membrane filters (FHHE) that are hydrophobic, with very fine mesh that stops water. We describe three basic physical tests (passage of water, passage of smoke and increase of resistance when applied to the patient) for filters to be classified. The ideal filter is hydrophobic and does not increase circuit resistance over the amount specified. Four principles are emphasized in the protocol: 1) the filter forms a part of the patient, not the apparatus; 2) proper placement of the filter is between the patient and the circuit's "Y" piece; 3) the main purpose of the filter is to prevent contamination of the apparatus, and 4) if a hydrophobic filter is used with each patient, the use of a disposable respiratory circuit is not called for.
Servicio de Anestesiología y Reanimación, Ciudad Sanitaria y Universitaria de Bellvitge, L'Hospitalet de Llobregat, Barcelona.
J
J
Cochs
P
P
Casals
R
R
Villalonga
A
A
Vences
J
J
Irujo
M
M
Suárez
D000328:Adult; D000336:Aerosols; D000768:Anesthesia, General / Q000295:instrumentation*; D002648:Child; D003428:Cross Infection / Q000517:prevention & control*; D004203:Disinfection / Q000191:economics / Q000379:methods; D004866:Equipment Contamination; D005374:Filtration / Q000295:instrumentation; D005740:Gases; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006509:Hepatitis B / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D012463:Saliva / Q000382:microbiology / Q000821:virology; D012906:Smoke; D012122:Ventilators, Mechanical; D014867:Water
D000336:Aerosols; D005740:Gases; D012906:Smoke; D014867:Water
Profilaxis de la contaminación cruzada, enfermo-aparato de anestesia-enfermo, mediante filtros.