湿备体外循环环路系统在手术室内保存期限的研究

Study on preservation life of previously primed cardiopulmonary bypass closed circuits in operating room

目的评估手术室湿备密闭的体外循环环路安全(不受细菌污染)时限。方法严格无菌条件下连接5套密闭的体外循环环路,采用2000ml勃脉力A液体预充和排气后,存放于北京安贞医院万级层流手术室内,分别于预充即刻、12、24、36、48、60、72h,在动脉滤器出口内侧、静脉总干内侧和膜式氧合器储血罐心内吸引连接处内侧抽取10ml预充液,直接接种培养,同时做手术间的空气细菌培养观察其菌落生长情况。结果所有时间点的空气培养均为阴性;5套体外循环管路分别在连接后即刻、24、48、60h时各处标本均未观察到菌落生长;72h时于其中1套体外循环环路的膜肺出口处取样标本中培养出表皮葡萄球菌。结论湿备体外循环环路存放于万级层流手术室条件下<60h是安全的。

OBJECTIVE To evaluate the preservation life of the previously assembled,primed and debubbled cardiopulmonary bypass（CPB） circuits in operating room.METHODS Five closed CPB circuits were assembled,primed with 2.0 liters of Plasma Lyte A solution and debubbled using aseptic technique and then were stored in the ten thousand laminar operating rooms in Beijing Anzhen Hospital.Each assembled CPB circuit was cultured at three different locations,including： on the internal side of outlet of the artery filter,on the internal side of the venous connector,and on the internal side of the sucker connector of the reservoir.Samples were taken by sterile cotton swabs immediately,12 h,24 h,36 h,48 h,60 h,and 72 h after primed and debubbled.10 ml of primed fluid was aseptically removed for microbiological culture,at the same time,the bacterial culture for the air in operating room was performed,and the growth of the bacterial colony was observed.RESULTS The bacterial culture for the air at all time points was negative;no bacterial colony was not observed on various locations of samples immediately,24 h,48 h and 60 h after 5 closed CPB circuits were connected;Staphylococcus epidermis was detected in one sample from outlet of membrane lung at 72 h.CONCLUSION The results of this investigation demonstrate that CPB circuit stored ＇wet primed＇ in operating room can be maintained sterilized for a period of 60 h when standard aseptic technique is applied.