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Using the standard MA-1 breathing circuit, the Cascade Heated Humidifier and tubing become rapidly contaminated with patient organisms. The rapidity with which this occurs seems to depend on the quantity and quality of patient secretions and dumping infected water from lazy loops into the Humidifier. Following modifications to the ventilator circuit which included: (1) closed system humidifier filling, (2) the addition of a small copper trap and drainage system to the inspired side of the breathing circuit, and (3) alteration of the heater, no contamination of the humidifier contents occurred for periods as long as 28 days. This trap was manufactured in our hospital using standard plumbing fixtures; a commercial model is available. This system is applicable to any volume ventilator using a heated reservoir humidifier.

We have evaluated a new clinical thermometer for accuracy. It determines temperature by measuring infrared radiation given off by a warm object. It was found to be accurate both in vivo and in vitro over the temperature range of 34.0 degrees to 39.5 degrees C. The in vivo assessment was made in patients in the ICU after their return from open heart surgery. The infrared tympanic thermometer tracked the core temperature (as measured by the thermistor tip of the pulmonary artery catheter) closely, with a correlation coefficient of 0.98, and took less than 2 sec to measure. We found this new thermometer to be accurate and, in our opinion, easily usable in the clinical situation.