Aerosol Distribution During Open Suctioning and Long-Term Surveillance of Air Quality in a Respiratory Care Center Within a Medical Center

Chung, Fen-Fang; Lin, Hui-Ling; Liu, Hsueh-Erh; Lien, Angela Shin‐Yu; Hsiao, Hsiu-Feng; Chou, Li Fang; Wan, Gwo-Hwa

doi:10.4187/respcare.03310

Cited by 20 publications

(13 citation statements)

References 28 publications

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“…A previous study found that when healthcare professionals performed the open-suction technique after disconnection from the ventilator system, the amount of suspended particles and bacterial concentration increased significantly, indicating an increased risk of exposure to biological aerosols [ 17 ]. Therefore, in order to maintain the safety of healthcare workers, it is recommended to avoid unnecessary ventilator system disconnection and the usage of a closed suction system to reduce the risk of bioaerosol exposure.…”

Section: Discussionmentioning

confidence: 99%

Potential risk for bacterial contamination in conventional reused ventilator systems and disposable closed ventilator-suction systems

Lin

Liao

et al. 2018

PLoS ONE

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BackgroundFew studies have investigated the difference in bacterial contamination between conventional reused ventilator systems and disposable closed ventilator-suction systems. The aim of this study was to investigate the bacterial contamination rates of the reused and disposable ventilator systems, and the association between system disconnection and bacterial contamination of ventilator systems.MethodsThe enrolled intubated and mechanically ventilated patients used a conventional reused ventilator system and a disposable closed ventilator-suction system, respectively, for a week; specimens were then collected from the ventilator circuit systems to evaluate human and environmental bacterial contamination. The sputum specimens from patients were also analyzed in this study.ResultsThe detection rate of bacteria in the conventional reused ventilator system was substantially higher than that in the disposable ventilator system. The inspiratory and expiratory limbs of the disposable closed ventilator-suction system had higher bacterial concentrations than the conventional reused ventilator system. The bacterial concentration in the heated humidifier of the reused ventilator system was significantly higher than that in the disposable ventilator system. Positive associations existed among the bacterial concentrations at different locations in the reused and disposable ventilator systems, respectively. The predominant bacteria identified in the reused and disposable ventilator systems included Acinetobacter spp., Bacillus cereus, Elizabethkingia spp., Pseudomonas spp., and Stenotrophomonas (Xan) maltophilia.ConclusionsBoth the reused and disposable ventilator systems had high bacterial contamination rates after one week of use. Disconnection of the ventilator systems should be avoided during system operation to decrease the risks of environmental pollution and human exposure, especially for the disposable ventilator system.Trial registrationClinicalTrials.gov PRS / NCT03359148

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Section: Discussionmentioning

confidence: 99%

Potential risk for bacterial contamination in conventional reused ventilator systems and disposable closed ventilator-suction systems

Lin

Liao

et al. 2018

PLoS ONE

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“…Four studies revealed that air samples obtained during open endotracheal suctioning in mechanically ventilated patients result in higher concentrations of particulate matter and pathogens like bacteria, viruses and fungi (Table 7) [ [36][37][38][39]. Three retrospective studies, evaluating risk factors for SARS-CoV-1 transmission while providing patient care to SARS patients did not demonstrate that endotracheal suctioning was a significant risk factor for SARS infection [34,40,41].…”

Section: Endotracheal Suctioningmentioning

confidence: 99%

“…Chung, 2015 [37] Environmental study N/A N/A Air samples in respiratory centre 1. Air quality samples were taken over 1 year and measured for particle mass and concentration.…”

Section: Directmentioning

confidence: 99%

Clinical evidence based review and recommendations of aerosol generating medical procedures in otolaryngology – head and neck surgery during the COVID-19 pandemic

Thamboo

Lea

Sommer

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

120

135

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Background: Aerosol generating medical procedures (AGMPs) present risks to health care workers (HCW) due to airborne transmission of pathogens. During the COVID-19 pandemic, it is essential for HCWs to recognize which procedures are potentially aerosolizing so that appropriate infection prevention precautions can be taken. The aim of this literature review was to identify potential AGMPs in Otolaryngology -Head and Neck Surgery and provide evidence-based recommendations.Methods: A literature search was performed on Medline, Embase and Cochrane Review databases up to April 3, 2020. All titles and abstracts of retrieved studies were evaluated and all studies mentioning potential AGMPs were included for formal review. Full text of included studies were assessed by two reviewers and the quality of the studies was evaluated. Ten categories of potential AGMPs were developed and recommendations were provided for each category.Results: Direct evidence indicates that CO2 laser ablation, the use of high-speed rotating devices, electrocautery and endotracheal suctioning are AGMPs. Indirect evidence indicates that tracheostomy should be considered as potential AGMPs. Nasal endoscopy and nasal packing/epistaxis management can result in droplet transmission, but it is unknown if these procedures also carry the risk of airborne transmission. Conclusions: During the COVID-19 pandemic, special care should be taken when CO2 lasers, electrocautery and high-speed rotating devices are used in potentially infected tissue. Tracheal procedures like tracheostomy and endotracheal suctioning can also result in airborne transmission via small virus containing aerosols.

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“…We also highly recommend attaching a filter to the intake side, because research has shown that fine particles and bacteria are present in room air within a respiratory care center. 5 In our study, the filter became considerably dirty in only 2 weeks.…”

Section: Hfnc/venturimentioning

confidence: 41%

Noise Exposure From High-Flow Nasal Cannula Oxygen Therapy: A Bench Study on Noise Reduction

et al. 2018

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Aerosol Distribution During Open Suctioning and Long-Term Surveillance of Air Quality in a Respiratory Care Center Within a Medical Center

Cited by 20 publications

References 28 publications

Potential risk for bacterial contamination in conventional reused ventilator systems and disposable closed ventilator-suction systems

Potential risk for bacterial contamination in conventional reused ventilator systems and disposable closed ventilator-suction systems

Clinical evidence based review and recommendations of aerosol generating medical procedures in otolaryngology – head and neck surgery during the COVID-19 pandemic

Noise Exposure From High-Flow Nasal Cannula Oxygen Therapy: A Bench Study on Noise Reduction

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