Validation of reprocessing process for breathing circuits used in ventilator and high-flow nasal cannula in a hospital

Athicha Kittiwattanokhun; Natthakit  Thirakittithanawong; Thanakorn Kwanchalernjai; Kitiya Fungprayun; Anong Anuwatthananon; Supattra Pongsak; Thanwa Pitaksuteepong; Theera Leeudomwong; Tassanai  Sanponpute

Authors

Athicha Kittiwattanokhun National Institute of Metrology (Thailand)
Natthakit Thirakittithanawong Phrapokklao Hospital, Chanthaburi Provinc
Thanakorn Kwanchalernjai Phrapokklao Hospital, Chanthaburi Provinc
Kitiya Fungprayun Phrapokklao Hospital, Chanthaburi Province
Anong Anuwatthananon Phrapokklao Hospital, Chanthaburi Province
Supattra Pongsak Phrapokklao Hospital, Chanthaburi Province
Thanwa Pitaksuteepong Phrapokklao Hospital, Chanthaburi Province
Theera Leeudomwong Faculty of Applied Science King Mongkut’s University of Technology North Bangkok
Tassanai Sanponpute National Institute of Metrology

Keywords:

reprocessing, breathing circuit, residual protein and blood testing, biological safety, leakage testing

Abstract

Phrapokklao Hospital currently consumes a large number of disposable medical devices, including critical equipment such as ventilator breathing circuits and high-flow nasal cannula (HFNC) circuits. These devices are typically discarded after a single use to minimize the risk of cross-infection, owing to concerns that conventional reprocesses may not completely eliminate microbial contamination. This study aimed to evaluate and validate the safety of reprocessing both reusable and single-use breathing circuits. A sample of swivel elbow connectors and tubes were tested for residual protein and blood after cleaning, followed by sterility and cytotoxicity assessments after sterilization. In addition, leak testing and visual inspections were performed on single use ventilator breathing circuits and HFNC circuits from three different brands currently used in the hospital.

The study revealed no residual protein or blood, no microbial growth, and no cytotoxic effects in the tested samples. Leak testing and visual inspections confirmed that the circuits remained in acceptable working condition, with only a slight increase in leakage observed after ten reuse cycles. These findings indicate that These findings indicate that single-use breathing circuits can be safely reused through effective reprocessing procedures, thereby substantially reduce both medical waste and healthcare costs without compromising patient safety. Nevertheless, further studies are required to validate long-term outcomes and to determine the broader applicability of this approach in clinical practice.

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