Aerosolization During Common Ventilation Scenarios. (16th June 2020)

• Record Type: Journal Article
• Authors: Xiao, Roy; Workman, Alan D.; Puka, Elefteria; Juang, Jeremy; Naunheim, Matthew R.; Song, Phillip C.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 163:Number 4(2020)
• Page Start: 702
• Page End: 704
• Publication Date: 2020-06-16
• Subjects: aerosol -- cough -- COVID‐19 -- intubation -- tracheostomy -- ventilation; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599820933595
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Otolaryngologists are at increased risk for exposure to suspected aerosol‐generating procedures during the ongoing coronavirus disease 2019 (COVID‐19) pandemic. In the present study, we sought to quantify differences in aerosol generation during common ventilation scenarios. We performed a series of 30‐second ventilation experiments on porcine larynx‐trachea‐lung specimens. We used an optical particle sizer to quantify the number of 1‐ to 10‐µm particles observed per 30‐second period (PP30). No significant aerosols were observed with ventilation of intubated specimens (10.8 ± 2.4 PP30 vs background 9.5 ± 2.1, P = 1.0000). Simulated coughing through a tracheostomy produced 53.5 ± 25.2 PP30, significantly more than background ( P =. 0121) and ventilation of an intubated specimen ( P =. 0401). These data suggest that undisturbed ventilation and thus intubation without stimulation or coughing may be safer than believed. Coughing increases aerosol production, particularly via tracheostomy. Otolaryngologists who frequently manage patient airways and perform tracheostomy are at increased risk for aerosol exposure and require appropriate personal protective equipment, especially during the ongoing COVID‐19 pandemic.