Open AccessAerosolization During Common Ventilation Scenarios
Author(s) -
Xiao Roy,
Workman Alan D.,
Puka Elefteria,
Juang Jeremy,
Naunheim Matthew R.,
Song Phillip C.
Publication year - 2020
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599820933595
Subject(s) - aerosolization , medicine , ventilation (architecture) , aerosol , covid-19 , intubation , mechanical ventilation , anesthesia , tracheotomy , tracheal intubation , intensive care medicine , inhalation , disease , meteorology , infectious disease (medical specialty) , physics
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.