HME-Filter versus patientenbezogener Wechsel der Beatmungsschlauchsysteme von Narkosegeräten

Abstract

Procedure-related costs were calculated for an operating theatre with 10 operating rooms. The variable parameter was the different hygiene regimens for the preparation of the anaesthesia circuit. In April 2003 a change was made for the whole anaesthesia area. Either change of the anaesthesia tube system after every patient or the use of a hydrophobic HME-F (heat and moisture exchange filter) with daily or weekly change of the anaesthesia tube system were calculated. All costs were ascertained on real findings and typical procedures. Data according to safety and hygienic value were discussed and supplemented by our own findings about perioperative pneumonia. The additional costs for the HME-F are covered by the savings for CO(2) lines and the reduction of reprocessing expenses and overall material costs were reduced. The operational work on anaesthesia machines decreased considerably. Combined cost types revealed savings up to 9,72 EUR for a single anaesthesia procedure. Filtration of the respiratory gases for particles, bacteria, viruses and airway climatisation is an additional positive effect of HME-F use. Incidence of postoperative pneumonia on intensive care units was monitored by KISS (German hospital infection surveillance system) and the change to the HME-F regimen did not indicate a higher risk of infection. By the implementation of a weekly change of the anaesthesia tube system using HME filters a hygienic management for anaesthesia circuit reprocessing was found which could mobilize considerable resources.

Level of respiratory protection against influenza virus

“…The protective tool to clear out the spreading of influenza virus is very important. It should be noted that regular replacement of the used filter has to be done because the contaminated filters can be the source for viral spreading [2]. In addition to the filters, the practitioners have to use self-protective device.…”

Infektionsprävention bei der Narkosebeatmung durch Einsatz von Atemsystemfiltern

“…Jedoch ist auf Grund fehlender Innenkontamination des Narkoseschlauchsystems nach dem ASF auch bei 7 Tage Liegedauer die gleiche Sicherheit gegeben [6]. Die postoperative Pneumonierate bei wöchentlichem Wechsel unterscheidet sich nicht von der Rate bei täglichem Wechsel [34] …”

Infection prevention during anaesthesia ventilation by the use of breathing system filters (BSF): Joint recommendation by German Society of Hospital Hygiene (DGKH) and German Society for Anaesthesiology and Intensive Care (DGAI)

“…As there is no internal contamination of the anaesthesia breathing system downstream of the BSF, the same degree of safety is given even after a 7 d period of use [13]. The postoperative pneumonia rate at a weekly change is not different from the rate at a daily change policy [39]. However, the functionality e.g.…”