Sterile Anesthesia Breathing Circuits Do Not Prevent Postoperative Pulmonary Infection

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Abstract
In a prospective, randomized trial, the effectiveness of sterile anesthesia breathing circuits that have bacterial filters to decrease the incidence of postoperative pulmonary infection was evaluated. Patients (293) undergoing major surgical procedures were assigned randomly to receive anesthetics through a sterile, disposable circuit having a bacterial filter, or a reusable circuit that was washed and dried after previous use. The 2 groups were well matched for age, sex, type of surgical procedure, type of anesthetic, and history of smoking or obstructive lung disease. A physician observer, who was unaware of these assignments, reviewed the patients'' postoperative status for evidence of pulmonary infection. The overall rate of infection was 3.5%, no significant difference in the rates of infection occurred between the 2 groups. Five (3.6%) of the 138 patients anesthetized with sterile circuits had postoperative respiratory infection, compared with 4 (2.6%)of the 155 patients anesthetized with unsterile circuits. In both groups, maximum postoperative temperature, white blood cell count and the lowest values for arterial O2 tension were similar. When simple hygienic measures are followed, the routine use of sterile anesthesia breathing circuits with bacterial filters evidently does not decrease the risk of postoperative infection.