Effect of tidal volume on fugitive emissions during mechanical ventilation
| Autor: | Gavin Bennett, Mary Joyce, James McGrath, Ronan MacLoughlin, Ciarraí O’Toole, Miriam Byrne |
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| Rok vydání: | 2018 |
| Předmět: |
Mechanical ventilation
business.industry Expiratory limb medicine.medical_treatment respiratory system Atmospheric sciences Aerosol 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Inspiratory limb Volume (thermodynamics) Low tidal volume Medicine 030212 general & internal medicine business Fugitive emissions Tidal volume |
| Zdroj: | Acute Critical Care. |
| DOI: | 10.1183/13993003.congress-2018.pa2319 |
| Popis: | Introduction: Secondary exposure to exhaled aerosols has been highlighted as a risk factor for bystanders during mechanical ventilation (Ari, A et al. Ind J Resp Care 2016; 5(1): 677-682). The aim of this study was to quantify exhaled aerosol emissions across high and low tidal volume settings during simulated adult mechanical ventilation. Methods: Aerosol was delivered during simulated adult mechanical ventilation using standard equipment (Bellavista 1000, IMT Medical, Switzerland). The ventilator was operated under the conditions 15BPM, I:E 1:2 at two tidal volumes of 276mL and 828mL. Tidal volumes were calculated based on a standard 69kg adult, 276mL and 828mL (4mL per kg and 12mL per kg respectively). 4mg of salbutamol was nebulised using a vibrating mesh nebuliser (Aerogen Solo, Aerogen, Ireland). The nebuliser was placed on the humidified inspiratory limb, before the Wye. Mass concentrations were recorded using two Aerodynamic Particle Sizer9s (Model 3321, TSI, USA) at two distances from the ventilator (n=3). Results: Table 1- Exhaled mass concentrations (mg/m3) at two distances from the nebuliser. Discussion: Aerosol mass concentrations were significantly greater when a tidal volume of 828mL was used in comparison to 276mL, thus indicating that aerosol emissions are influenced by ventilator parameters. At higher tidal volumes, the increased exhaled volume results in a greater quantity of aerosol being released. These findings support the often ignored recommendation for placement of a filter on the expiratory limb of the circuit, in an effort to reduce emissions during mechanical ventilation. |
| Databáze: | OpenAIRE |
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