Aerosol Generation from the Respiratory Tract with Various Modes of Oxygen Delivery.
Aerosol Generation from the Respiratory Tract with Various Modes of Oxygen Delivery.
复制标题
从呼吸道产生的气溶胶以各种氧气递送方式产生。
DOI：
10.1164/rccm.202006-2309oc
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发表时间：
2020-10-15
影响因子：
24.7
通讯作者：
Hogan CJ Jr
中科院分区：
文献类型：
--
作者：
Gaeckle NT;Lee J;Park Y;Kreykes G;Evans MD;Hogan CJ Jr
理论基础：在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行期间，使用高流量鼻管和无创正压通气等氧气治疗模式产生气雾剂是医护人员关注的问题。用这些不同的氧气形式从呼吸道产生的气雾剂的量是未知的。目的：测量不同供氧方式下人体呼吸道产生的颗粒物和液滴的大小和数量浓度。方法：选择10例无活动性肺部疾病的健康受试者。供氧方式包括非湿化鼻腔插管、面罩、加温加湿高流量鼻腔插管和无创正压通气。当参与者进行正常呼吸、说话、深呼吸和咳嗽时，测量每种氧气模式下的气溶胶生成。测试是在负压室中进行的。用空气动力学颗粒谱仪测量了直径在0.37~20μm之间的颗粒。测量和主要结果：颗粒物浓度的中位数在0.041到0.168颗粒/厘米~3之间。中位数直径在1.01~1.53μm之间。咳嗽显著增加了所测颗粒物的数量。无论是使用湿化的高流量鼻腔插管还是使用非侵入性正压通气，测量的气溶胶浓度都没有显著增加。这是在正常呼吸、说话、深呼吸和咳嗽时的情况。结论：在负压室中测量没有活动性肺部疾病的健康受试者中，湿化高流量鼻管和无创正压通气的氧气输送方式不会增加呼吸道气雾剂的产生。
Rationale: Aerosol generation with modes of oxygen therapy such as high-flow nasal cannula and noninvasive positive-pressure ventilation is a concern for healthcare workers during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The amount of aerosol generation from the respiratory tract with these various oxygen modalities is unknown. Objectives: To measure the size and number concentration of particles and droplets generated from the respiratory tract of humans exposed to various oxygen delivery modalities. Methods: Ten healthy participants with no active pulmonary disease were enrolled. Oxygen modalities tested included nonhumidified nasal cannula, face mask, heated and humidified high-flow nasal cannula, and noninvasive positive-pressure ventilation. Aerosol generation was measured with each oxygen mode while participants performed maneuvers of normal breathing, talking, deep breathing, and coughing. Testing was conducted in a negative-pressure room. Particles with a diameter between 0.37 and 20 μm were measured using an aerodynamic particle spectrometer. Measurements and Main Results: Median particle concentration ranged from 0.041 to 0.168 particles/cm3. Median diameter ranged from 1.01 to 1.53 μm. Cough significantly increased the number of particles measured. Measured aerosol concentration did not significantly increase with the use of either humidified high-flow nasal cannula or noninvasive positive-pressure ventilation. This was the case during normal breathing, talking, deep breathing, and coughing. Conclusions: Oxygen delivery modalities of humidified high-flow nasal cannula and noninvasive positive-pressure ventilation do not increase aerosol generation from the respiratory tract in healthy human participants with no active pulmonary disease measured in a negative-pressure room.