Exhaled air dispersion during bag-mask ventilation and sputum suctioning - Implications for infection control.
Exhaled air dispersion during bag-mask ventilation and sputum suctioning - Implications for infection control.
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DOI：
10.1038/s41598-017-18614-1
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发表时间：
2018-01-09
影响因子：
4.6
通讯作者：
Hui DS
中科院分区：
文献类型：
--
作者：
Chan MTV;Chow BK;Lo T;Ko FW;Ng SS;Gin T;Hui DS
面罩通气和经口气管吸痰期间的咳嗽产生气溶胶，增强呼吸道感染的医院传播。我们研究了不同人群的医护人员和咳嗽发作在面罩通气期间从人类患者模拟器呼出的空气扩散的程度。模拟器被编程为模拟不同严重程度的肺损伤。呼出的气流被标记为微小的烟雾颗粒，并通过激光光片突出显示。我们确定了标准化的呼出气体浓度泄漏射流羽流从光散射的烟雾颗粒。烟雾浓度≥20%被视为显著暴露。由护士操作的Ambu硅胶复苏器在横平面上从面罩-面部界面漏气最严重（267 ± 44 mm）。然而，使用Ambu或Laerdal硅胶复苏器的麻醉师/重症监护医师、呼吸科医生和医学生之间的离散度相似，p = 0.974。在没有气管插管的情况下，正常咳嗽努力期间的最大离散度为860 ± 93 mm，并随着咳嗽努力的加重而降低。口-气管吸痰显著降低了离散度，p < 0.001，持续吸痰更有效。在面罩通气过程中确保良好贴合的技能对于防止面罩-面部界面的空气泄漏非常重要。在进行气溶胶生成程序时，连续的经口气管吸引可最大限度地减少咳嗽发作期间呼出的空气分散。
Mask ventilation and coughing during oro-tracheal suctioning produce aerosols that enhance nosocomial transmission of respiratory infections. We examined the extent of exhaled air dispersion from a human-patient-simulator during mask ventilation by different groups of healthcare workers and coughing bouts. The simulator was programmed to mimic varying severity of lung injury. Exhaled airflow was marked with tiny smoke particles, and highlighted by laser light-sheet. We determined the normalized exhaled air concentration in the leakage jet plume from the light scattered by smoke particles. Smoke concentration ≥20% was considered as significant exposure. Exhaled air leaked from mask-face interface in the transverse plane was most severe (267 ± 44 mm) with Ambu silicone resuscitator performed by nurses. Dispersion was however similar among anesthesiologists/intensivists, respiratory physicians and medical students using Ambu or Laerdal silicone resuscitator, p = 0.974. The largest dispersion was 860 ± 93 mm during normal coughing effort without tracheal intubation and decreased with worsening coughing efforts. Oro-tracheal suctioning reduced dispersion significantly, p < 0.001, and was more effective when applied continuously. Skills to ensure good fit during mask ventilation are important in preventing air leakage through the mask-face interface. Continuous oro-tracheal suctioning minimized exhaled air dispersion during coughing bouts when performing aerosol-generating procedures.
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通过简单的氧气掩模在氧气输送过程中呼出的空气分散体。
影响因子：
9.6
作者：
Hui DS;Hall SD;Chan MT;Chow BK;Ng SS;Gin T;Sung JJ
通讯作者：
Sung JJ
影响因子：
3.6
作者：
Simonds, A. K.;Hanak, A.;Dickinson, R. J.
通讯作者：
Dickinson, R. J.
影响因子：
9.6
作者：
Hui, David S.;Chow, Benny K.;Chan, Matthew T. V.
通讯作者：
Chan, Matthew T. V.
气溶胶生成程序和将急性呼吸道感染传播给医疗保健工作者的风险：系统评价。
影响因子：
3.7
作者：
Tran K;Cimon K;Severn M;Pessoa-Silva CL;Conly J
通讯作者：
Conly J
影响因子：
9.6
作者：
Hui, David S.;Chow, Benny K.;Chan, Matthew T. V.
通讯作者：
Chan, Matthew T. V.