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Table of Contents
LETTER TO EDITOR  
Year : 2015  |  Volume : 18  |  Issue : 1  |  Page : 104
In response to "positive end-expiratory pressure valve malfunctioning detected by capnographic and airway pressure waveform"


Department of Anaesthesiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India

Click here for correspondence address and email

Date of Web Publication1-Jan-2015
 

How to cite this article:
Choudhury P, Singha SK. In response to "positive end-expiratory pressure valve malfunctioning detected by capnographic and airway pressure waveform". Ann Card Anaesth 2015;18:104

How to cite this URL:
Choudhury P, Singha SK. In response to "positive end-expiratory pressure valve malfunctioning detected by capnographic and airway pressure waveform". Ann Card Anaesth [serial online] 2015 [cited 2019 Jul 21];18:104. Available from: http://www.annals.in/text.asp?2015/18/1/104/148332


The Editor,

We have read with great interest the article "positive end-expiratory pressure (PEEP) valve malfunctioning detected by capnographic and airway pressure waveform", [1] and understand the serious consequences of PEEP valve malfunction. We feel that such malfunction should be prevented as it can jeopardize the ventilation as well as the safe administration of anesthesia. In light of the same, we would like to mention the recommendations given in the instruction manual of Dräger Fabius GS anesthesia workstation from Draeger Medical Inc. (Telford, PA, USA) for cleaning, and disinfection of the PEEP valve discs. [2]

The recommendations are:

  1. Wet pasteurization at 70°C/158°F for 30 min after detergent cleaning
  2. Immersion (glutaraldehyde based formulations of 2%)
  3. Autoclaving (including steam and hot air at 134°C/273°F).


It is recommended that the above mentioned procedure should be scheduled after each patient use. However, the authors of the cited article mention that the workstation underwent service 7 months prior to the incident reported but no regular cleaning was performed for the PEEP valve discs as directed by the manufacturer. Apparently, the PEEP valve malfunction was due to improper maintenance and service that led to the excessive moisture accumulation and the stuck PEEP valve disc. Needless to emphasize, the anesthesia machine including PEEP valve should undergo regular maintenance and service as per instructions given in the manual, strict adherence to given recommendations would prevent machine failure as well as the PEEP valve malfunction, and ensure safe conduct of anesthesia and ventilation.

 
   References Top

1.
Solanki SL, Doctor JR, Patil VP, Rana M. Positive end-expiratory pressure valve malfunctioning detected by capnography and airway pressure waveform. Ann Card Anaesth 2014;17:255-7.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Dräger Medical Operator's Instruction Manual, Fabius GS Software Version 1.3. no. 12 September 2003. p. 110.  Back to cited text no. 2
    

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Correspondence Address:
Subrata Kumar Singha
Department of Anaesthesiology, All India Institute of Medical Sciences, Tatibandh, GE Road, Raipur 492 099, Chhattisgarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.148332

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