Five-Year Experience With the Development of an Individually Clean Anesthesia System

It has been clearly demonstrated in both the operating room and in the laboratory that all parts of an anesthesia breathing circuit may become contaminated. We have solved this problem by having a completely clean system for each patient. Retrospective evaluation of 220 patient charts revealed that the incidence of postoperative pulmonary infection dropped from 23 percent before such cleanup to 6 percent after. With partial cleanup of everything but the absorber, the incidence of infection was still high (26 percent), and not until there was total cleanup of the circuit, employing a disposable absorber, did the incidence drop to 6 percent. Considering the protective physiology of the upper airway and the tremendous changes created by anesthetic agents and procedures, it is no wonder that the surgical patient has a high morbidity related to pulmonary infection. It is mandatory that the anesthesiologist not introduce bacteria or viruses via the inhalation system into this vulnerable individual. We feel the answer to this problem is to have a completely clean circuit for each patient.