Multipac Breathing System
Intersurgicals Multipac Breathing System allows reuse of
anaesthesia breathing circuits (BC) resulting in cost savings
and reduced medical waste.
Authors: R Daggan, CRNA, MS, D.Steinberg, M.D., G.Larijani, We demonstrated that the use of circuits with appropriate
PharmD.I Gratz, D.O., A Zafeiridis phD, ME Goldberg, MD. filters does not result in bacterial contamination. Since
filter size is 0.017µm, known viral particles are not
Affiliation; The Cooper Heath System/UMDNJ, Department expected to penetrate the filter. We use 55 (BC) daily.
of Anaesthesiology, Robert Wood Johnson Medical School
at Camden, NJ Assuming reuse of 36 (BC), 250 operation days, and weight
of 1 lb/ (BC), the savings from waste disposal are $2,727/ yr
Introduction: Previously we demonstrated that (BC) can (36 BC x 250 days x $0.303/ BC). Moreover, with the cost
be recycled resulting in cost and environmental savings1. In of our current (BC) AT $13.16, the savings associated with
the past practitioners have reused washed anesthesia the reusable circuits (36/ day), are $108,452/ yr. The cost of
circuits, but with the rise of universal precautions this reusable (BC) includes $5.75/ (BC) and $5.00/ case for new
practice has disappeared. With the development of specific filter, elbow, and mask. The total savings for waste disposal
viral and bacterial filters the possibility of newer circuits and (BC) are $111,179/ yr. We conclude that reuse of (BC)
being reused needs to be investigated. The purpose of this results in considerable cost savings without risks of viral
study was to determine if Intersurgical’s Filtatherm filter and bacterial transmission.
between the patient and the (BC) prevents contamination
and allows the reuse of Intersurgical’s Multipac circuit with
considerable cost savings.
1. Jml of Clin Anes 1996; 8:475-479
Method: After obtaining IRB approval, FDA reviewed filters
Example of a Multipac circuit
and reusable (BC) were used to study 52 patients. Prior to
anesthesia cultures were obtained from (BC) at the Y piece
distal to the filter (using patient as reference point), and at
Change unit each patient
the inspiratory and expiratory ports proximal to the
anesthesia machine. Immediately after anesthesia, cultures
were obtained from the proximal end of the endotracheal
tube at the Murphy eye, and the Y piece distal to the filter.
The cultures were incubated and the results examined at
24 and 48 hours. The cost of red bag waste and the
number of (BC) used in the operating room annually were
calculated. We assumed that in contaminated cases
(respiratory tract infection, frank blood and secretions
within the circuit) we would not reutilize the circuit. The
cost of our current practice of disposing (BC) after each
use was compared with the cost after reusing the (BC).
Results: All 52 cultures obtained at the endotracheal tube
site (patient side of the filter) grew various organisms such
as Candida albicans, Alpha Streptococcus, Neisseria species,
Staph Species, Proteus species, Non-hemolytic Strep,
Keep for duration of day
Corynebacterium, Gram negative rods, Klebsiella, and
Pseudomonas. Prior to anesthesia cultures of Y piece, and
the inspired and expired ports showed no growth after 48
hrs. However, two circuits demonstrated growths in the
expiratory port (streptococcus, neisseria and enterobacter)
as a result of culture contamination. Following anesthesia
all 52 Y piece cultures (machine side of filter) showed
negative growths after 48 hrs of incubation.
Multipac circuits are custom built to individual requirements
417 Electronics Parkway • Liverpool, NY 13088-6098
I N C O R P O R AT E D phone: (315) 451-2900 • fax: (315) 451-3696