RT Journal Article
SR Electronic
T1 Evaluating cross contamination on a shared ventilator
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 220
OP 223
DO 10.1136/emermed-2020-209972
VO 38
IS 3
A1 Donald Joseph Doukas
A1 Lorenzo Paladino
A1 Christopher Hanuscin
A1 Jonathan McMahon
A1 John Quale
A1 Isha Bhatt
A1 Julie Eason
A1 Mark Silverberg
YR 2021
UL http://emj.bmj.com/content/38/3/220.abstract
AB Background Disasters have the potential to cause critical shortages of life-saving equipment. It has been postulated that during patient surge, multiple individuals could be maintained on a single ventilator. This was supported by a previous trial that showed one ventilator could support four sheep. The goal of our study is to investigate if cross contamination of pathological agents occurs between individuals on a shared ventilator with strategically placed antimicrobial filters.Methods A multipatient ventilator circuit was assembled using four sterile, parallel standard tubing circuits attached to four 2 L anaesthesia bags, each representing a simulated patient. Each ‘patient’ was attached to a Heat and Moisture Exchange filter. An additional bacterial/viral filter was attached to each expiratory limb. ‘Patient-Lung’ number 1 was inoculated with an isolate of Serratia marcescens, and the circuit was run for 24 hours. Each ‘lung’ and three points in the expiratory limb tubing were washed with broth and cultured. All cultures were incubated for 48 hours with subcultures performed at 24 hours.Results Washed cultures of patient 2, 3 and 4 failed to demonstrate growth of S. marcescens. Cultures of the distal expiratory tubing, expiratory limb connector and expiratory limb prefilter tubing yielded no growth of S. marcescens at 24 or 48 hours.Conclusion Based on this circuit configuration, it is plausible to maintain four individuals on a single ventilator for 24 hours without fear of cross contamination.