Endotracheal Tube as a Source of Infection

Smith, Joanne R.

doi:10.1001/jama.1959.73000210001009

Cited by 12 publications

(1 citation statement)

References 7 publications

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“…Although the storage of the clean circuits did not involve sterile packaging, decontamination procedure was apparently able to reduce the contamination of the circuits. This is in agreement with the results of other authors (Joseph, 1952;Stratford, Clark and Dixson, 1964;Mecks, Pembleton and Hench, 1967;Enright, Moore and Parney, 1976), who found a considerable contamination of the anaesthetic equipment after use; however, only slight contamination was found by Smith and Howland (1959). Furthermore, the bacterial content of the anaesthetic gas mixture from cleansed circuits (4.2 x 10~2 litre-1 ) was only 1.3 times greater than that in the gas supplied from the anaesthetic machine (3.5 x 10~2 bacteria litre-1 ) and considerably less than the bacterial content of normal hospital air from surgical and medical wards and operating theatres (21.2 x 10~2 to 85.8 x 10-2 bacteria litre" 1 (Siboni, I960)).…”

Section: Discussionsupporting

confidence: 93%

Bacterial Contamination of Anaesthetic Gases

Nielsen

Vasegaard

Stokke

1978

British Journal of Anaesthesia

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The bacterial content of oxygen and nitrous oxide immediately before and after passing through clean and used breathing systems (circuits) was measured using a specially constructed agar chamber (Bourdillon's slit sampler). The content per litre of oxygen from the outlet of the anaesthetic machine was 4.0 X 10-2, and 2.9 X 10-2 for nitrous oxide, corresponding to 3.5 X 10-2 for a 50% mixture of the gases. After passing through cleaned circuits, the bacterial pollution of the gas mixture had increased by 30%, but more than elevenfold after passing through used circuits. The content from cleaned circuits was less than that measured previously in the air of hospital wards and operating theatres, whereas gases from used circuits were polluted to approximately the same extent. It is concluded that used circuits may increase the risk of cross-infection. The cleaning method employed by us (dish-washer--hot airy drying) appeared to be acceptable.

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Section: Discussionsupporting

confidence: 93%

Bacterial Contamination of Anaesthetic Gases

Nielsen

Vasegaard

Stokke

1978

British Journal of Anaesthesia

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Comparison of Anesthetic Methods in Elective Surgery

Minster¹

1964

Arch Surg

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Sterilization of Anesthesia Apparatus

Meeks¹,

Pembleton²,

Hench³

1967

JAMA

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THE importance of sterilization of anesthesia equipment and the relationship between contaminated equipment and subsequent infection has not been established.It has been recommended that since anesthesia equipment is exposed to a heavily contaminated area of the body meticulous care should be exercised in the handling and sterilization of apparatus.1 Other workers, however, have either failed to detect significant contamination in a considerable part of the apparatus2 or have concluded that it was unlikely that cross-infection would occur.3-5 Sterilization of anesthesia equipment presents a rather difficult problem. Although certain items can apparently be sterilized by satisfactory techniques, bulky rubber items do not lend themselves to these techniques, and, in addition, must be processed in considerable quantity to meet the demands of a busy operating schedule. Germicides which are effective against certain organisms under certain conditions may be unsatisfactory under other conditions. Chemicals which have been found to be good bactericidal agents may be unsatisfactory because they are corrosive. This study was undertaken to determine the extent and character of contamination of anesthe¬ sia equipment, and to determine the effectiveness of a new germicide, buffered glutaraldehyde.8 Method Face masks, breathing tubes, rebreathing bags, endotracheal tubes, and Y connectors used in anes¬ thesia for operations in two wings of the operating suite were cultured after use and again after clean¬ ing with one of the following routines.Routine A.-Face masks, breathing tubes, and rebreathing bags were thoroughly washed in hexachlorophene and water, and connectors and endo¬ tracheal tubes were cleaned by brushing with hexachlorophene and water. All items were then thoroughly rinsed and soaked in 70% ethyl alcohol for 20 minutes.Routine B.-The above routine of cleaning with hexachlorophene followed by rinsing was carried out, and then all items were soaked in a solution of buffered glutaraldhyde for ten minutes.Equipment used for operations in one wing of the operating suite was subjected to routine A and that of the other wing was subjected to routine B on any given day. On alternate days the order of cleaning was reversed. Equipment used in 100 op¬ erations was selected for the testing of each of the routines.Representative items of anesthesia equipment were selected. In the course of the experiment 100 samples were taken from face masks, 100 from breathing bags, and 100 from Y connectors, and 200 were taken from rebreathing tubes (since there are two tubes in each set) for each of the cleaning routines. The samples were taken after use and again after employing one of the cleaning routines. Since endotracheal techniques were not employed in all of the operations, fewer endotracheal tubes were available for the test.Sample equipment from five additional cases was processed with cleaning routine B, cultured, and stored in plastic bags previously sterilized with ethylene-oxide. At intervals of 6, 30, 54, 78, and 102 hour...

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Endotracheal Tube as a Source of Infection

Cited by 12 publications

References 7 publications

Bacterial Contamination of Anaesthetic Gases

Bacterial Contamination of Anaesthetic Gases

Comparison of Anesthetic Methods in Elective Surgery

Sterilization of Anesthesia Apparatus

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