Computational modelling of an aerosol extraction device for use in COVID-19 surgical tracheotomy

Abstract

In view of the ongoing COVID-19 pandemic and its effects on global health, understanding and accurately modelling the propagation of human biological aerosols has become crucial. Worldwide, health professionals have been one of the most affected demographics, representing approximately 20% of all cases in Spain, 10% in Italy and 4% in China and US. Methods to contain and remove potentially infected aerosols during Aerosol Generating Procedures (AGPs) near source offer advantages in reducing the contamination of protective clothing and the surrounding theatre equipment and space. In this work we describe the application of computational fluid dynamics in assessing the performance of a prototype extraction hood as a means to contain a high speed aerosol jet. Whilst the particular prototype device is intended to be used during tracheotomies, which are increasingly common in the wake of COVID-19, the underlying physics can be adapted to design similar machines for other AGPs. Computational modelling aspect of this study was largely carried out by Barcelona Supercomputing Center using the high performance computational mechanics code Alya. Based on the high fidelity LES coupled with Lagrangian frameworks the results demonstrate high containment efficiency of generated particles is feasible with achievable air extraction rates.

Design Requirements of Robotic Systems for Assisting Percutaneous Tracheostomy: A Scoping Review and Development Framework

“…• Development of a tracheostomy robot prototype [31] • Design of other devices related to tracheostomy [32] • Development of robots for MISs [37], [39], [40] • Reviews of surgical robots [34], [36], [42] • Design specifications of surgical robots [33], [35], [38], [41], [43] A summary, including brief descriptions and requirements collected from each study, is shown in Table I. After synthesizing all the information, 36 potential design requirements were developed and listed in Fig.…”

Control of airborne particles in surgical procedures during the Covid-19 pandemic: scoping review

“…As for the recommendations on surgical procedures, these range from the selection of the anesthetic modality, the adequate manipulation of the airways, to the execution of the surgical technique ( 12 , 20 , 21 , 24 ) . In the context of the Covid-19 pandemic, the main objective is to reduce the production and dispersion of air particles as much as possible, opting for procedures that do not produce aerosols, gases or fumes ( 20 , 45 ) . Whenever possible, anesthesia through locoregional blocks should be used, considering that general anesthesia requires manipulation of the pathways, with ventilation maneuvers, tracheal intubation and, consequently, aerosol production ( 17 , 18 ) .…”

“…Recommendations /CDC 2020/ English/US air particles as much as possible, opting for procedures that do not produce aerosols, gases or fumes (20,45) . Whenever possible, anesthesia through locoregional blocks should be used, considering that general anesthesia requires manipulation of the pathways, with ventilation maneuvers, tracheal intubation and, consequently, aerosol production (17)(18) .…”

Controle de partículas aéreas nos procedimentos cirúrgicos durante a pandemia da Covid-19: revisão de escopo

“…Quanto às recomendações sobre os procedimentos cirúrgicos, estas vão desde a escolha da modalidade anestésica, a manipulação adequada de vias aéreas, até a execução da técnica cirúrgica (12,(20)(21)24) . No contexto da pandemia da Covid-19, o objetivo principal é reduzir ao máximo a produção e a dispersão de partículas aéreas, optando por procedimentos que não produzam aerossol, gases ou fumaças (20,45) . Sempre que possível, deve-se utilizar a anestesia por bloqueios locorregionais, considerando que a anestesia geral requer a manipulação de vias, com manobra de ventilação, intubação traqueal e consequentemente produção de aerossol (17)(18) .…”