Negative pressure face shield for flexible laryngoscopy in theCOVID-19 era
Negative pressure face shield for flexible laryngoscopy in theCOVID-19 era
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DOI：
10.1002/lio2.437
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发表时间：
2020-07-29
影响因子：
1.9
通讯作者：
Diekema, Daniel J.
中科院分区：
文献类型：
--
作者：
Hoffman, Henry T.;Miller, Robert M.;Diekema, Daniel J.
目的：在新冠肺炎时代实施经鼻气溶胶产生过程中，引入限制微滴传播的新方法和新材料。方法：对负压面罩（NPFS）的原型进行测试，然后用于临床，以创建一个可控制进入口鼻的吸力清除负压微环境。在原型内进行气压测量后，对30名连续接受该设备治疗的患者进行前瞻性评估，通过问卷调查和监测血氧仪进行评估。结果：NPFS是一个透明的丙烯酸屏障，有两个前内固定口和一个连续吸吸的侧口。它被放置在一个支架上，并采用一次性抗菌包装来固定头部周围的外壳。该组件成功地用于所有30例患者的经鼻喉镜检查。设计的耐受性非常好，术后问卷调查显示无呼吸短促（27/30），无幽闭恐惧症（27/30），无疼痛（29/30），脉搏血氧饱和度无显著变化。结论：诊断性喉镜检查成功地在负压微环境中进行，以限制气溶胶的分散。NPFS设备的进一步应用目标是用于经鼻喉激光和活检手术，随后进行额外的修改，使鼻内和口内手术在类似的保护环境中使用。证据水平：2b级（队列研究）。
Objective: Introduce novel methods and materials to limit microdroplet spread when performing transnasal aerosol generating procedures in the COVID-19 era.Methods: Prototypes of a negative pressure face shield (NPFS) were tested then used clinically to create a suction-clearing negative pressure microenvironment with controlled access to the nose and mouth. Air pressure measurements within prototypes were followed by prospective evaluation of 30 consecutive patients treated with the device assessed through questionnaires and monitoring oximetry.Results: The NPFS is a transparent acrylic barrier with two anterior instrumentation ports and a side port to which continuous suction is applied. It is positioned on a stand and employs a disposable antimicrobial wrap to secure an enclosure around the head. This assembly was successfully used to complete transnasal laryngoscopy in all 30 patients studied. Tolerance of the design was excellent, with postprocedure questionnaire identifying no shortness of breath (27/30), no claustrophobia (27/30), no pain (29/30), and no significant changes in pulse oximetry.Conclusion: Diagnostic laryngoscopy was successfully performed in a negative pressure microenvironment created to limit dispersion of aerosols. Further application of the NPFS device is targeted for use with transnasal laryngeal laser and biopsy procedures to be followed by additional modification to enable intranasal and intraoral procedures in a similar protected environment.Level of Evidence: Level 2b (Cohort Study).