Quantification of aerosol dispersal from suspected aerosol-generating procedures
Background Oxygen-delivering modalities like humidified high-flow nasal cannula (HFNC) and noninvasive positive-pressure ventilation (NIV) are suspected of generating aerosols that may contribute to transmission of disease such as coronavirus disease 2019. We sought to assess if these modalities lea...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2021-12-01
|
| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/7/4/00206-2021.full |
| _version_ | 1818753561607012352 |
|---|---|
| author | Runar Strand-Amundsen Christian Tronstad Ole Elvebakk Tormod Martinsen Marius Dybwad Egil Lingaas Tor Inge Tønnessen |
| author_facet | Runar Strand-Amundsen Christian Tronstad Ole Elvebakk Tormod Martinsen Marius Dybwad Egil Lingaas Tor Inge Tønnessen |
| author_sort | Runar Strand-Amundsen |
| collection | DOAJ |
| description | Background
Oxygen-delivering modalities like humidified high-flow nasal cannula (HFNC) and noninvasive positive-pressure ventilation (NIV) are suspected of generating aerosols that may contribute to transmission of disease such as coronavirus disease 2019. We sought to assess if these modalities lead to increased aerosol dispersal compared to the use of non-humidified low-flow nasal cannula oxygen treatment (LFNC).
Methods
Aerosol dispersal from 20 healthy volunteers using HFNC, LFNC and NIV oxygen treatment was measured in a controlled chamber. We investigated effects related to coughing and using a surgical face mask in combination with the oxygen delivering modalities. An aerodynamic particle sizer measured aerosol particles (APS3321, 0.3–20 µm) directly in front of the subjects, while a mesh of smaller particle sensors (SPS30, 0.3–10 µm) was distributed in the test chamber.
Results
Non-productive coughing led to significant increases in particle dispersal close to the face when using LFNC and HFNC but not when using NIV. HFNC or NIV did not lead to a statistically significant increase in aerosol dispersal compared to LFNC. With non-productive cough in a room without air changes, there was a significant drop in particle levels between 100 cm and 180 cm from the subjects.
Conclusions
Our results indicate that using HFNC and NIV does not lead to increased aerosol dispersal compared to low-flow oxygen treatment, except in rare cases. For a subject with non-productive cough, NIV with double-limb circuit and non-vented mask may be a favourable choice to reduce the risk for aerosol spread. |
| first_indexed | 2024-12-18T05:09:19Z |
| format | Article |
| id | doaj.art-a4ff18e4be0e4219a518859cde15be4c |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-12-18T05:09:19Z |
| publishDate | 2021-12-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-a4ff18e4be0e4219a518859cde15be4c2022-12-21T21:19:56ZengEuropean Respiratory SocietyERJ Open Research2312-05412021-12-017410.1183/23120541.00206-202100206-2021Quantification of aerosol dispersal from suspected aerosol-generating proceduresRunar Strand-Amundsen0Christian Tronstad1Ole Elvebakk2Tormod Martinsen3Marius Dybwad4Egil Lingaas5Tor Inge Tønnessen6 Dept of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway Dept of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway Dept of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway Dept of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway Norwegian Defence Research Establishment (FFI), Kjeller, Norway Dept of Infection Prevention, Oslo University Hospital – Rikshospitalet, Oslo, Norway Dept of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway Background Oxygen-delivering modalities like humidified high-flow nasal cannula (HFNC) and noninvasive positive-pressure ventilation (NIV) are suspected of generating aerosols that may contribute to transmission of disease such as coronavirus disease 2019. We sought to assess if these modalities lead to increased aerosol dispersal compared to the use of non-humidified low-flow nasal cannula oxygen treatment (LFNC). Methods Aerosol dispersal from 20 healthy volunteers using HFNC, LFNC and NIV oxygen treatment was measured in a controlled chamber. We investigated effects related to coughing and using a surgical face mask in combination with the oxygen delivering modalities. An aerodynamic particle sizer measured aerosol particles (APS3321, 0.3–20 µm) directly in front of the subjects, while a mesh of smaller particle sensors (SPS30, 0.3–10 µm) was distributed in the test chamber. Results Non-productive coughing led to significant increases in particle dispersal close to the face when using LFNC and HFNC but not when using NIV. HFNC or NIV did not lead to a statistically significant increase in aerosol dispersal compared to LFNC. With non-productive cough in a room without air changes, there was a significant drop in particle levels between 100 cm and 180 cm from the subjects. Conclusions Our results indicate that using HFNC and NIV does not lead to increased aerosol dispersal compared to low-flow oxygen treatment, except in rare cases. For a subject with non-productive cough, NIV with double-limb circuit and non-vented mask may be a favourable choice to reduce the risk for aerosol spread.http://openres.ersjournals.com/content/7/4/00206-2021.full |
| spellingShingle | Runar Strand-Amundsen Christian Tronstad Ole Elvebakk Tormod Martinsen Marius Dybwad Egil Lingaas Tor Inge Tønnessen Quantification of aerosol dispersal from suspected aerosol-generating procedures ERJ Open Research |
| title | Quantification of aerosol dispersal from suspected aerosol-generating procedures |
| title_full | Quantification of aerosol dispersal from suspected aerosol-generating procedures |
| title_fullStr | Quantification of aerosol dispersal from suspected aerosol-generating procedures |
| title_full_unstemmed | Quantification of aerosol dispersal from suspected aerosol-generating procedures |
| title_short | Quantification of aerosol dispersal from suspected aerosol-generating procedures |
| title_sort | quantification of aerosol dispersal from suspected aerosol generating procedures |
| url | http://openres.ersjournals.com/content/7/4/00206-2021.full |
| work_keys_str_mv | AT runarstrandamundsen quantificationofaerosoldispersalfromsuspectedaerosolgeneratingprocedures AT christiantronstad quantificationofaerosoldispersalfromsuspectedaerosolgeneratingprocedures AT oleelvebakk quantificationofaerosoldispersalfromsuspectedaerosolgeneratingprocedures AT tormodmartinsen quantificationofaerosoldispersalfromsuspectedaerosolgeneratingprocedures AT mariusdybwad quantificationofaerosoldispersalfromsuspectedaerosolgeneratingprocedures AT egillingaas quantificationofaerosoldispersalfromsuspectedaerosolgeneratingprocedures AT toringetønnessen quantificationofaerosoldispersalfromsuspectedaerosolgeneratingprocedures |