Particle generation during positive airway pressure therapy.
About: This article is published in Sleep Medicine.The article was published on 2021-05-18 and is currently open access. It has received 1 citations till now.
Citations
More filters
TL;DR: In the past 2 years, many studies have assessed the transmission risk posed by various respiratory care procedures, and recommendations for mitigating transmission risk based on the current evidence are discussed in this narrative review.
Abstract: During the early phase of the COVID-19 pandemic, many respiratory therapies were classified as aerosol-generating procedures. This categorization resulted in a broad range of clinical concerns and a shortage of essential medical resources for some patients. In the past 2 years, many studies have assessed the transmission risk posed by various respiratory care procedures. These studies are discussed in this narrative review, with recommendations for mitigating transmission risk based on the current evidence.
7 citations
References
More filters
TL;DR: Identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China, and it is shown that this virus belongs to the species of SARSr-CoV, indicates that the virus is related to a bat coronav virus.
Abstract: Since the outbreak of severe acute respiratory syndrome (SARS) 18 years ago, a large number of SARS-related coronaviruses (SARSr-CoVs) have been discovered in their natural reservoir host, bats1–4. Previous studies have shown that some bat SARSr-CoVs have the potential to infect humans5–7. Here we report the identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, which started on 12 December 2019, had caused 2,794 laboratory-confirmed infections including 80 deaths by 26 January 2020. Full-length genome sequences were obtained from five patients at an early stage of the outbreak. The sequences are almost identical and share 79.6% sequence identity to SARS-CoV. Furthermore, we show that 2019-nCoV is 96% identical at the whole-genome level to a bat coronavirus. Pairwise protein sequence analysis of seven conserved non-structural proteins domains show that this virus belongs to the species of SARSr-CoV. In addition, 2019-nCoV virus isolated from the bronchoalveolar lavage fluid of a critically ill patient could be neutralized by sera from several patients. Notably, we confirmed that 2019-nCoV uses the same cell entry receptor—angiotensin converting enzyme II (ACE2)—as SARS-CoV. Characterization of full-length genome sequences from patients infected with a new coronavirus (2019-nCoV) shows that the sequences are nearly identical and indicates that the virus is related to a bat coronavirus.
16,857 citations
TL;DR: 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.
Abstract: 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.
114 citations
TL;DR: Analysis suggests that for viral loads, often corresponding to mild-to-moderate cases of COVID-19, droplets of diameter < 20 µm at the time of emission (equivalent to ~ 10 µm desiccated residue diameter) are unlikely to be of consequence in carrying infections.
Abstract: For rebooting economic activities in the ongoing COVID-19 pandemic scenario, it is important to pay detailed attention to infection transfer mechanisms during interaction of people in enclosed environments. Utmost concern is the possibility of aerosol mediated infection transfer, which is largely governed by the size distributions of virus laden droplets, termed as virusols in this work, ejected from humans. We expand on the well-known theory of Poisson fluctuations which acts as statistical barrier against formation of virusols. Analysis suggests that for viral loads < 2 × 105 RNA copies/mL, often corresponding to mild-to-moderate cases of COVID-19, droplets of diameter < 20 µm at the time of emission (equivalent to ~ 10 µm desiccated residue diameter) are unlikely to be of consequence in carrying infections. Cut-off diameters below which droplets will be practically free of contamination, are presented as a function of viral loading. The median diameters of virus laden polydisperse droplet distributions will be 1.5 to 20 times higher depending upon the geometric standard deviation. The studies have implications to risk assessment as well as residence time estimates of airborne infections in indoor environments. Additionally, it will be also helpful for performance evaluation of sanitization and control technologies to mitigate infection risks in workplaces.
80 citations
TL;DR: Among surveyed sleep centers, the vast majority reported near-cessation of in-laboratory sleep studies, while a smaller proportion reported reductions in HSATs, and a large increase in the use of telemedicine was reported, with the majority of respondents expecting theUse of telehealth to endure in the future.
Abstract: Study Objectives:The COVID-19 pandemic required sleep centers to consider and implement infection control strategies to mitigate viral transmission to patients and staff. Our aim was to assess meas...
47 citations
28 citations