1996 OPEN FORUM Abstracts
THE ECONOMIC OUTCOME OF REPROCESSING DISPOSABLE HEATED WIRE VENTILATOR CIRCUITS.
Thomas J. Kallstrom R.R.T. and Robert L. Chatburn R.R.T. Rainbow Babies and Childrens Hospital, Cleveland.
Introduction: In 1985 the CDC revoked their earlier stance against the reprocessing and reuse of single-use items. However, they did state that anyone who reprocesses single-use equipment must consider the safety and efficacy of such a practice. Disposable ventilator circuits are manufactured with the intent that the user will discard the circuit after one use. With the tightening of our supply budget we sought to ascertain if it would be safe to reuse these circuits. We also wanted to determine if this would result in a cost savings. Methods: We obtained heated wire resistance specifications from the manufacturer (Baxter) for pediatric, infant and adult circuits. All used ventilator circuits not visibly soiled were placed into a HEPA filtered air dryer. Visibly soiled circuits were discarded. After a drying cycle the circuits were placed into plastic bags, sealed and disinfected with ethylene oxide gas. After disinfection the circuit resistance was aseptically measured by an equipment technician. If the heated wire circuit remained within tolerance it was judged acceptable for reuse. If not it was discarded. Results: In a one year period we reused 1.087 circuits. Our policy was to change circuits every 7 days unless the patient was extubated before this time. We found that there were only 4 infant circuits and 1 pediatric circuit that had failed after disinfection.
Reuse (annual) No Reuse (annual)
Labor (730 hrs/yr. @ $10.74/hr.): $7,840 N/A
Cleaning and sterilization $7,942 N/A
Purchase of new circuits $12,406 $26,305
Reuse costs $1,883/year more than single use. Conclusions: We have been able to demonstrate that we can reuse heated wire circuits safely and with minimal damage to the circuit. Our circuit failure rate was 0.5%. Reusing disposable ventilator circuits must be weighed carefully in relation to the cost, inconvenience, space that reprocessing equipment entails. Also, the safety and efficacy of reprocessing disposable equipment must be judged on an individual institutional basis. Ultimately the burden of proof is on the respiratory care department. More research should be done as little can be found in the literature on this topic.