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Prevention of submicron aerosolized particle dispersion: evaluation of an aerosol box using a pediatric simulation
Laurence Tabone1,2, Dominic Rivest3, Arielle Levy4
1Pediatric Intensive Care, Department of Pediatrics, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada.
Insights
The SplashGuard CG (SG) may reduce aerosolized particle (AP) exposure during pediatric ventilation, but only under specific conditions (closed ports, suction in spontaneous ventilation). High AP levels persist inside the device, necessitating cautious use.
Area of Science:
- Medical Devices
- Infectious Disease Control
- Pediatric Respiratory Care
Background:
- Healthcare workers face SARS-CoV-2 transmission risks during aerosol-generating procedures.
- The SplashGuard CG (SG) is a barrier enclosure designed to mitigate these risks.
- Evaluating the SG's efficacy in pediatric settings is crucial.
Purpose of the Study:
- To assess the protective capability of the SplashGuard CG (SG) against aerosolized particles (AP).
- To evaluate SG performance in pediatric simulation models under spontaneous ventilation (SV) and noninvasive ventilation (NIV).
Main Methods:
- A pediatric high-fidelity manikin with a breathing simulator was used.
- Aerosol generators delivered particles to simulate respiratory procedures.
- AP concentrations were measured inside and outside the SG under various conditions (SV, NIV, with/without suction, open/closed ports).
Main Results:
- In spontaneous ventilation (SV), the SG reduced AP peaks when ports were closed and suction was applied (0.1 × 10⁵ particles/L vs. 1.6 × 10⁵ particles/L without SG).
- In noninvasive ventilation (NIV), AP peaks outside the SG were consistently lower than without SG, especially with suction and closed ports (0.7 × 10⁵ particles/L).
- AP concentrations measured inside the SG were significantly higher than outside, even with suction applied in both SV and NIV.
Conclusions:
- The SG demonstrated a potential to decrease peak AP exposure in specific pediatric ventilation scenarios (SV with closed ports and suction).
- However, substantial AP concentrations remained within the SG, even with suction.
- The study advises cautious use of the SG due to persistent high AP levels inside the enclosure.
Abstract:
Background and Aim: The SplashGuard CG (SG) is a barrier enclosure developed to protect healthcare workers from SARS-CoV-2 transmission during aerosol-generating procedures. Our objective was to evaluate the protection provided by the SG against aerosolized particles (AP), using a pediatric simulation model of spontaneous ventilation (SV) and noninvasive ventilation (NIV). Methods: An aerosol generator was connected to the airways of a pediatric high-fidelity manikin with a breathing simulator. AP concentrations were measured both in SV and NIV in the following conditions: with and without SG, inside and outside the SG, with and without suction applied to the device. Results: In the SV simulated setting, AP peaks were lower with SG: 0.1 × 105 particles/L compared to without: 1.6 × 105, only when the ports were closed and suction applied. In the NIV simulated setting, AP peaks outside the SG were lower than without SG (20.5 × 105 particles/L), whatever the situation, without suction (14.4 × 105particles/L), with suction and ports open or closed: 10.3 and 0.7 × 105 particles/L. In SV and NIV simulated settings, the AP peaks measured within the SG were much higher than the AP peaks measured without SG, even when suction was applied to the device. Conclusions: The SG seems to decrease peak AP exposure in the 2 ventilation contexts, but only with closed port and suction in SV. However, high concentrations of AP remain inside even with suction and SG should be used cautiously.
