Lung volume equipment and infection control. ERS/ATS Workshop Report Series. European Respiratory Society/American Thoracic Society

Abstract

As part of the consensus workshop regarding lung volume measurements for the American Thoracic Society and European Respiratory Society, this background paper reviews mechanisms and risks of cross-infection resultant from performing measurements of absolute lung volumes either by body plethysmography, gas dilution, or gas wash-out techniques. Published reports of infection attributable to the performance of lung volume measurements are extremely rare. Nevertheless, because some infectious agents could be transmitted during measurements of lung volumes, and because of widespread concerns both of patients and some medical personnel about the risks of transmission of infections during inspiration from equipment used by other patients, a variety of measures have been advocated to minimize the risks of cross-infection.Workshop participants were divided in opinion about whether such testing does indeed pose significant risk of cross-infection, and also could not agree regarding optimal measures to prevent cross-infection. Although there is conflicting information regarding the efficacy of particulate filters for protecting cross-contamination of downstream equipment and tubing, the author recommends that such filters be used when making lung volume measurements, but only if the filter has acceptably low resistance (e.g. <0.15 kPa·L -1 ·s (1.5 cmH 2 O·L -1 ·s)), and the measurements are adjusted for the impact of the added resistance and dead space.

Standardisation of the measurement of lung volumes

“…The NHLBI workshop participants, who were experts with considerable adult and paediatric experience, published their input in the form of background papers in the European Respiratory Journal between 1995 and 1999 [2][3][4][5][6][7][8][9][10][11][12]. Later, a NHLBI workshop consensus document was written, which can be found on the ATS website [13], for those who require more in-depth descriptions, discussion and a fuller derivation of equations.…”

Clinical evaluation of a screen pneumotachograph as an in-line filter

“…The appropriate placement of filters with ideally 100% effectiveness for trapping pathogenic organisms from exhaled air during pulmonary function testing would thus appear to be the most practical method for eliminating transmission of pathogenic organisms between patients [10], and, inasmuch as in-line filters have been shown to be effective in removing pathogens from the expiratory flow [11] without affecting the clinical utility of respiratory function tests [3,[12][13][14], their use might be encouraged in the clinical laboratory. Patient advocate groups, with the help of their medical committees, have published recommendations including the mandatory use of in-line filters during spirometry, and many laboratory managers have generalised the use of such filters.…”

Turkish Thoracic Society national spirometry and laboratory standards

“…Ortamda ortaya çıkan biyolojik atıklar uygun şekilde yok edilmelidir (24,25). İnfekte olan ve olmayan atık-ların ayrılması da infeksiyon kontrolüne yardım eder.…”