医院呼吸机管路污染状况调查

Investigation on Contamination of Ventilator Circuits in Hospital

目的了解医院呼吸机管路污染状况,为提出呼吸机相关性肺炎(VAP)防控措施的改进意见提供依据。方法对两种配置的呼吸机管路进行调查采样,检测管路内不同部位的细菌总数,比较不同配置呼吸机管路污染情况。结果呼吸机管路越靠近病人端污染越严重,高配置呼吸机管路近病人段7 d时细菌总数比低配置呼吸机的高,湿化罐的污染问题较突出,呼吸机管路近主机段污染较少。结论国内不同配置的呼吸机管路存在各自的污染问题,对没有气道阻塞性疾病的患者应考虑使用细菌过滤型湿热交换器。呼吸机管路使用30 d污染状况严重,需按照卫生部门的推荐每周更换管路。

Objectives To investigate the contamination situation of ventilator circuits in hospital, provide the reference for improving the measures of Ventilator-associated pneumonia （VAP） control and prevention Methods The ventilators with two kinds of configuration were investigated and sampled. By detecting total bacterial count on several parts of the ventilator circuit, the contamination situation of ventilator circuits with different configuration were compared. Results The parts closer to patient in ventilator circuit had been more heavily contaminated. On the 7th day, the total bacterial count of ventilator with advanced configuration was larger than that of basic configuration. The contamination of humidifier was noticeable, and the parts of ventilator circuit closer to main engine were contaminated lightly. Conclusions There were different contamination problems of ventilator circuit with different configuration. The heat and moisture exchange filters should be used for the patients without obstructive airways disease. The ventilator circuits used for 30 days are contaminated seriously, they should be changed every week according to the recommendation of health administration.