Covid-19 Shines New Spotlight on Breathing Filters: What Do the Experts Say?
The Importance of “High Quality” Airway Filters - Between Breathing Circuit & Patient’s Airways
December 4, 2020
In anesthesiology the prevention of healthcare-associated infections (HCAI) has been discussed for decades1 and the use of breathing filters has been recommended for the prevention of tuberculosis, influenza and hepatitis C. 2-6
COVID‐19: Societies Recommend the Use of Breathing Filters
Today the world is facing an unprecedented healthcare crisis caused by a pandemic novel beta coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In terms of the COVID‐19 pandemic, national and international societies have been quick to cotton on to the new situation. Organizations like The European Resuscitation Council, the British NHS, the US American Anesthesia Patient Safety Foundation and the Safe Airway Society of Australia / New Zealand have all stressed the importance of placing “high quality” airway filters between the breathing circuit and the patient’s airways to “prevent circuit contamination and minimize aerosolization in expired gas” – in short, to minimize the risk of virus spread.7-10
Expert Opinion Survey: What is the Most Important Filter Quality?
We conducted a survey and let 200 experts from France, Germany, the UK and the USA have their say: Clinicians (anesthesiologists, intensive care specialists, anesthesia tech staff) and admin staff (nurses and managers) in the operating room and on the ICU stated what they would rate as the filters’ most important qualities, when they choose one.
The Product Makes The Difference: “Highest Bacterial / Viral Efficiency” is the Most Important Quality
Two thirds (66%) of the respondents answer that the product’s performance makes the difference and is the number one decisive factor, when choosing a breathing filter. This is made up of 29% of all respondents believing that the “highest bacterial / viral efficiency” of a filter is especially important and 37% of all respondents valuing additional product performance parameters, including “best resistance to wetting / clogging” (15%), “longest filter life” (14%) and “largest number of times you can nebulize through the filter” (8%).
Graphic 1: Answers of survey respondents (in %) to the question: Which level of importance you place around each factor when choosing a breathing system filter?
Breathing System Filter users as well as professional organizations acknowledge the need for high efficiency filtration during anesthesia and intensive care ventilation. In laboratory studies as well as in clinical trials Pall Breathing System Filters have been shown to retain both airborne microorganisms at >99.999% and liquid borne bacteria and viruses at 100% efficiency, including Influenza A, Hepatitis C, HIV and Mycobacterium tuberculosis.
- Zorrilla-Vaca A., Escandón-Vargas K. (2017). The importance of infection control and prevention in anesthesiology. Rev Colomb Anestisiol. 45(S 2):69–77
- CDC (2005). Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings. [online]. Available at: http://www.cdc.gov/mmwr/pdf/rr/rr5417.pdf. [Accessed 19 August. 2020]
- Sprung CL, Zimmerman JL, Christian MD, et al. (2010). Recommendations for intensive care unit and hospital preparations for an influenza epidemic or mass disaster: summary report of the European Society of Intensive Care Medicine’s Task Force for intensive care unit triage during an influenza epidemic or mass disaster. Intensive Care Medicine 2010; 36: 428–43
- Blood Borne Viruses Advisory Panel. A Report Received by Council of the Association of Anaesthetists on Blood Borne Viruses and Anaesthesia: An Update (January 1996). London: The Association of Anaesthetists of Great Britain and Ireland, 1996.
- Association of Anaesthetists of Great Britain and Ireland. Infection Control in Anaesthesia. London: The Association of Anaesthetists of Great Britain and Ireland, 2002.
- Association of Anaesthetists of Great Britain and Ireland. Infection control in anaesthesia. Anaesthesia 2008; 63: 1027–36.
- NHS (2020). Guidance for the role and use of non-invasive respiratory support in adult patients with COVID19 (confirmed or suspected). [online] NHS. Available at: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/specialty- guide-NIV-respiratory-support-and-coronavirus-v3.pdf [Accessed 19 August. 2020]
- Safe Airway Society. (2020). Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. [online]. Available at: https://www.mja.com.au/journal/2020/consensus-statement-safe-airway- society-principles-airway-management-and-tracheal [Accessed 19 August. 2020]
- Anesthesia Patient Safety Foundation. (2020). FAQ ON ANESTHESIA MACHINE USE, PROTECTION, AND DECONTAMINATION DURING THE COVID-19 PANDEMIC. [online]. Available at: https://www.apsf.org/faq-on-anesthesia-machine-use-protection-and- decontamination-during-the-covid-19-pandemic/ [Accessed 19 August. 2020]
- European Resuscitation Council. (2020). European Resuscitation Council COVID-19 Guidelines. [online]. Available at: https://www.erc.edu/sites/5714e77d5e615861f00f7d18/pages/5e9ac62b4c84867335e4d1e b/files/ERC_covid19_pages.pdf?1591110476 [Accessed 19 August. 2020]
- Kramer A. et al. (2010). Infection prevention during anaesthesia ventilation by the use of breathing system filters (BSF): Joint recommendation by German Society of Hospital Hygiene (DGKH) and German Society for Anaesthesiology and Intensive Care (DGAI). GMS Krankenhaushygiene Interdisziplinär. 5(2):1-19
Dr. Volker Luibl, MBA
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