Blood-Containing Aerosols Generated by Surgical Techniques a Possible Infectious Hazard

Jewett, Don L.; Heinsohn, Patricia A.; Bennett, Craig; Rosen, Alan; Neuilly, Cyril

doi:10.1080/15298669291359564

Cited by 97 publications

(62 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The factors taken into consideration included the severe compromise of each patient's lung function, which contributed to high anesthetic risk, and, most importantly, the ongoing SARS in each patient, which posed a potential infection risk to all operating room staff. 12 It was envisaged that endotracheal intubation, positive-pressure ventilation, lung manipulation during surgery, and the process of postoperative extubation might increase the risk of releasing virus-laden droplets into the operating theater environment. In the presence of a new infectious disease, the means of transmission of which had not been determined at the time, this represented a serious consideration.…”

Section: Resultsmentioning

confidence: 99%

Severe Acute Respiratory Syndrome Complicated by Spontaneous Pneumothorax

Sihoe

Wong

Lee

et al. 2004

Chest

107

117

View full text Add to dashboard Cite

Severe acute respiratory syndrome (SARS) presents an unprecedented diagnostic and therapeutic challenge to clinicians. Despite recent progress in identifying and analyzing the coronavirus that is responsible for it, few reports have addressed the clinical complications of SARS. The present study was a two-center retrospective cohort study. All patients in the study had SARS, were managed in the two major Hong Kong hospitals (ie, Prince of Wales Hospital and United Christian Hospital), and had developed spontaneous pneumothorax during their hospitalization between March 10, 2003, and April 28, 2003. Spontaneous pneumothorax was reported in 6 of 356 SARS patients who were treated at the two hospitals during the period. This represents an incidence of 1.7%. None of the six patients had a history of smoking or pulmonary disease. The rate of admission to the ICU was 66.7% and the crude mortality rate was 33.3% in this group of patients. There was a trend for the mean neutrophil count in these patients to be higher than in previously reported cohorts of comparable SARS patients (14.5 x 10(9) vs 4.6 x 10(9) neutrophils per liter, respectively). Conservative measures like tube thoracostomy or observation alone offered satisfactory initial symptomatic management in five of six patients. Spontaneous pneumothorax is a specific and potentially life-threatening complication in SARS patients. Patients with extensive lung injury, as indicated by severe clinical courses, and in particular high neutrophil counts, appear to be most at risk. The benefits of surgical management must be balanced against the potential risks to health-care workers.

show abstract

Section: Resultsmentioning

confidence: 99%

Severe Acute Respiratory Syndrome Complicated by Spontaneous Pneumothorax

Sihoe

Wong

Lee

et al. 2004

Chest

107

117

View full text Add to dashboard Cite

show abstract

“…On the other hand, surgical instruments are known to produce submicron-sized particles that carry viable viral particles. 7 Furthermore, a study has shown that particles of up to 22 mm in size enter the respiratory zone when these masks are worn. 8 In conclusion, our data show that no combination of multiple surgical masks was able to meet the requirements for a respirator.…”

Section: Discussionmentioning

confidence: 99%

Protecting healthcare staff from severe acute respiratory syndrome: filtration capacity of multiple surgical masks

Derrick

Gomersall

2005

Journal of Hospital Infection

106

View full text Add to dashboard Cite

Guidelines issued by the Centers for Disease Control and Prevention and the World Health Organisation state that healthcare workers should wear N95 masks or higher-level protection during all contact with suspected severe acute respiratory syndrome (SARS). In areas where N95 masks are not available, multiple layers of surgical masks have been tried to prevent transmission of SARS. The in vivo filtration capacity of a single surgical mask is known to be poor. However, the filtration capacity of a combination of masks is unknown. This was a crossover trial of one, two, three and five surgical masks in six volunteers to determine the in vivo filtration efficiency of wearing more than one surgical mask. We used a Portacount to measure the difference in ambient particle counts inside and outside the masks. The best combination of five surgical masks scored a fit factor of 13.7, which is well below the minimum level of 100 required for a half face respirator. Multiple surgical masks filter ambient particles poorly. They should not be used as a substitute for N95 masks unless there is no alternative.

show abstract

“…In the field of dentistry and orthopedics, where high-powered electric tools are used, even bloodborne viruses (such as human immunodeficiency virus -HIV, hepatitis B and hepatitis B viruses) can become airborne when they are contained in high velocity blood splatter generated by these instruments [18,19]. Yet, whether they can cause efficient transmission via this route is more debatable.…”

Section: The Importance Of Ambient Airflows and The Of Aerosolsmentioning

confidence: 99%

Recognition of aerosol transmission of infectious agents: a commentary

et al. 2019

View full text Add to dashboard Cite

Although short-range large-droplet transmission is possible for most respiratory infectious agents, deciding on whether the same agent is also airborne has a potentially huge impact on the types (and costs) of infection control interventions that are required.The concept and definition of aerosols is also discussed, as is the concept of large droplet transmission, and airborne transmission which is meant by most authors to be synonymous with aerosol transmission, although some use the term to mean either large droplet or aerosol transmission.However, these terms are often used confusingly when discussing specific infection control interventions for individual pathogens that are accepted to be mostly transmitted by the airborne (aerosol) route (e.g. tuberculosis, measles and chickenpox). It is therefore important to clarify such terminology, where a particular intervention, like the type of personal protective equipment (PPE) to be used, is deemed adequate to intervene for this potential mode of transmission, i.e. at an N95 rather than surgical mask level requirement.With this in mind, this review considers the commonly used term of ‘aerosol transmission’ in the context of some infectious agents that are well-recognized to be transmissible via the airborne route. It also discusses other agents, like influenza virus, where the potential for airborne transmission is much more dependent on various host, viral and environmental factors, and where its potential for aerosol transmission may be underestimated.

show abstract

Blood-Containing Aerosols Generated by Surgical Techniques a Possible Infectious Hazard

Cited by 97 publications

References 0 publications

Severe Acute Respiratory Syndrome Complicated by Spontaneous Pneumothorax

Severe Acute Respiratory Syndrome Complicated by Spontaneous Pneumothorax

Protecting healthcare staff from severe acute respiratory syndrome: filtration capacity of multiple surgical masks

Recognition of aerosol transmission of infectious agents: a commentary

Contact Info

Product

Resources

About