密闭的体外膜肺氧合系统干备的无菌性研究

Sterility of previously assembled extracorporeal membrane oxygenation circuits

目的评估"干备"的体外膜肺氧合(ECMO)系统能否在长达35 d的时间内保持无菌。方法严格无菌条件下组装5套密闭的ECMO系统(MAQUET,BE-PLS 2050),置于百级层流手术间内35 d,在预组装完成当天及第3、7、14、21、28、35天分别于离心泵前、泵后膜前、膜肺后3个部位使用无菌棉签对管路内取样,做细菌培养。同期对手术间内的空气进行细菌培养作为对照。最后对透明盒中的管路表面进行分段取样,观察有无细菌生长。结果同期的空气培养均为阴性。除了第35天ECMO环路4膜肺后培养出表皮葡萄球菌外,余管路内及透明盒中的管路表面取样标本均未观察到细菌菌落生长。结论"干备"的ECMO系统放置于百级层流手术间,28 d内使用是无菌和安全的;透明盒中的管路表面在35 d内是无菌和安全的。"干备"ECMO系统可以缩短ECMO的启动时间,从而降低急危重症患者的病死率。

Objective To evaluate whether the assembled extracorporeal membrane oxygenation(ECMO)circuits without priming could remain sterile for up to 35 days.Methods The five ECMO circuits(MAQUET,BE-PLS 2050)were assembled without priming in aseptic conditions,and were remained in the hundred level laminar flow operating room for 35 days.Samples in circuit were taken by sterile cotton swabs on the same,3rd,7th,14th,21st,28th and 35th days after pre-assembling.Each assembled ECMO circuit was sampled at three locations,as follows:the inlet of centrifugal pump,inlet of membrane oxygenator,outlet of membrane oxygenator.The air culture of the operating room was used as a reference.Finally,the surface of tubes in the transparent box were sampled to observe whether there was bacterial growth.Results The results of air culture were negative at all the points of time.There were no positive bacterial cultures in all the specimens except Staphylococcus epidermidis from outlet of membrane oxygenator on the 35th day.At last,there was no bacterial growth on the surface of the tubes in transparent box.Conclusions The assembled ECMO circuits without priming can be maintained sterile and safe for 28 days when placed in a hundred level laminar flow operating room.The surfaces of tubes in transparent box are sterile and safe for 35 days.The assembled ECMO circuits without priming can shorter the run-up time,so as to reduce the case fatality rate of critically ill patients.