2018
DOI: 10.1038/s41598-017-18614-1
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Exhaled air dispersion during bag-mask ventilation and sputum suctioning - Implications for infection control

Abstract: Mask ventilation and coughing during oro-tracheal suctioning produce aerosols that enhance nosocomial transmission of respiratory infections. We examined the extent of exhaled air dispersion from a human-patient-simulator during mask ventilation by different groups of healthcare workers and coughing bouts. The simulator was programmed to mimic varying severity of lung injury. Exhaled airflow was marked with tiny smoke particles, and highlighted by laser light-sheet. We determined the normalized exhaled air con… Show more

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Cited by 63 publications
(77 citation statements)
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“…54 In a series of physiological experiments, Chan et al programmed an adult simulator to mimic varying severities of lung injury. 55,56 When a tidal volume (VT) of 300 mL was applied, air dispersion reached up to 0.3 to 0.35 m. Presumably, lower VT would produce less air dispersion. Indeed, in another experiment using noninvasive ventilation, a five-fold decrease in VT was associated with a 30% reduction in air dispersion.…”
Section: Manual Ventilationmentioning
confidence: 99%
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“…54 In a series of physiological experiments, Chan et al programmed an adult simulator to mimic varying severities of lung injury. 55,56 When a tidal volume (VT) of 300 mL was applied, air dispersion reached up to 0.3 to 0.35 m. Presumably, lower VT would produce less air dispersion. Indeed, in another experiment using noninvasive ventilation, a five-fold decrease in VT was associated with a 30% reduction in air dispersion.…”
Section: Manual Ventilationmentioning
confidence: 99%
“…Technical skills to minimize exhaled air dispersion is also paramount since inexperienced HCW can increase the spread by 40%. 55 Thus, in neonatal respiratory care, avoidance of manual ventilation solely for the purpose of preventing air dispersion appears unnecessary.…”
Section: Manual Ventilationmentioning
confidence: 99%
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“…19 Other than the general benefits of reduced pain and opioid consumption, postoperative pulmonary complications, postoperative nausea and vomiting, and possibly postoperative cognitive dysfunction and delirium offered by RA over GA (with systemic opioids), 20 the main advantage in patients with infectious respiratory viral diseases would be the avoidance of airway instrumentation and patient coughing during intubation and extubation, 21,22 thus reducing the risk of infecting staff via the associated aerosol generation and dispersion of viral particles. 23 Secondly, and broadly speaking, RA has fewer effects on respiratory function and dynamics compared with GA with or without muscle paralysis. [24][25][26] This relative preservation of respiratory function could theoretically reduce postoperative pulmonary complications in COVID-19 patients who may already have reduced respiratory function from COVID-19-associated pneumonia or acute respiratory distress syndrome.…”
mentioning
confidence: 99%