Aerosol generation with the use of positive pressure ventilation via supraglottic airway devices: an observational study.

Autor: Deng W; Department of Mechanical Engineering, City University of Hong Kong, Hong Kong Special Administrative Region, China., Nestor CC; Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, China., Leung KMM; Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, China., Chew J; Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, China., Wang H; Department of Mechanical Engineering, City University of Hong Kong, Hong Kong Special Administrative Region, China., Wang S; Department of Mechanical Engineering, City University of Hong Kong, Hong Kong Special Administrative Region, China., Irwin MG; Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
Jazyk: angličtina
Zdroj: Anaesthesia [Anaesthesia] 2023 Sep; Vol. 78 (9), pp. 1112-1119. Date of Electronic Publication: 2023 Jun 28.
DOI: 10.1111/anae.16078
Abstrakt: The amount of aerosol generation associated with the use of positive pressure ventilation via a supraglottic airway device has not been quantified. We conducted a two-group, two-centre, prospective cohort study in which we recruited 21 low-risk adult patients scheduled for elective surgery under general anaesthesia with second-generation supraglottic airway devices. An optical particle sizer and an isokinetic sampling probe were used to record particle concentrations per second at different size distributions (0.3-10 μm) during use as well as baseline levels during two common activities (conversation and coughing). There was a median (IQR [range]) peak increase of 2.8 (1.5-4.5 [1-28.1]) and 4.1 (2.0-7.1 [1-18.2]) times background concentrations during SAD insertion and removal. Most of the particles generated during supraglottic airway insertion (85.0%) and removal (85.3%) were < 3 μm diameter. Median (IQR [range]) aerosol concentration generated by insertion (1.1 (0.6-5.1 [0.2-22.3]) particles.cm -3 ) and removal (2.1 (0.5-3.0 [0.1-18.9]) particles.cm -3 ) of SADs were significantly lower than those produced during continuous talking (44.5 (28.3-70.5 [2.0-134.5]) particles.cm -3 ) and coughing (141.0 (98.3-202.8 [4.0-296.5]) particles.cm -3 ) (p < 0.001). The aerosol levels produced were similar with the two devices. The proportion of easily inhaled and small particles (<1 μm) produced during insertion (57.5%) and removal (57.5%) was much lower than during talking (99.1%) and coughing (99.6%). These results suggest that the use of supraglottic airway devices in low-risk patients, even with positive pressure ventilation, generates fewer aerosols than speaking and coughing in awake patients.
(© 2023 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.)
Databáze: MEDLINE
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