The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

FEASIBILITY OF RECYCLING DISPOSABLE CAPNOMETER ADAPTERS

Robert Messenger BS. RRT, Maricel Endrekson BS, Alfred F. Connors, Jr., MD. Respiratory Care Division - Pulmonary Services Department, MetroHealth Medical Center, Cleveland, OH.

Introduction: The N-6000 capnometer (Nellcor-Puritan-Bennett, Haywood, CA) employs a disposable "single patient use only" mainstream airway adapter (ADAP-UC). We sought to determine the effect of repeated clinical use and sterilization of the mainstream airway adapter on the accuracy of this capnometer. Method: 30 new airway adapters were labeled and numbered. Each adapter was evaluated using a callbrated capnometer which was restricted to use only for this study. A certified gas (5.07% CO_{2}), meeting the manufacturer's specifications for sensor verification was passed at 2 lpm through the adapter via a sampling system designed to eliminate contamination with ambient air, and the resulting values were recorded. After the initial test, all of the adapters were placed into clinical service until either the capnographic wavefrom dampened or end-tidal monitoring was no longer indicated. Next the adapters were cleaned of gross matter using either a nylon tube brush or cotton tipped swabs then sterilized by soaking in a could activated gluteraldehyde solution for 30 minutes, followed by a 20 minute water rinse and drying in a tube dryer. Each adapter was tested again by the previously described method and the results recorded. 26 of the original 30 adapters underwent 10 use- sterilization-testing cycles, while 4 adapters were lost or disposed of before completing 10 cycles during the 5 month testing period. Results: At no point in the study did any adapter yield a CO_{2} value outside of the 5.07 ± 0.3% range specified by the manufacturer. See table below:

Adapters n=26 Test gas [CO_{2}]= 5.07%

Test Initia 1 2 3 4 5 6 7 8 9 10

Mean 5.13 5.12 5.14 5.16 5.16 5.15 5.14 5.15 5.16 5.15 5.14

High 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3 5.3

Low 4.9 5.0 5.0 4.9 5.0 5.0 5.0 5.0 5.0 5.0 5.0

SD 0.09 0.10 0.10 0.10 0.10 0.07 0.08 0.08 0.08 0.09 0.10

There was no significant difference among test groups using one-way ANOVA (p=0.915). Conclusion: Following cold sterilization, these disposable adapters continue to provide accurate CO_{2} concentration values, and can be safely recycled 10 times. Further study is necessary to determine the maximum number of adapter reuses that are consistent with safe and reliable performance.

Reference: OF-96-063

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