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Area of Science:

  • Pulmonary Medicine
  • Infectious Disease Control
  • Respiratory Care

Background:

  • Bronchoscopy is an aerosol-generating procedure (AGP) with potential risks for healthcare providers due to viral pathogen exposure.
  • Understanding aerosol generation patterns during different bronchoscopy aspects is crucial for infection control.
  • This study aims to characterize aerosol generation during flexible and rigid bronchoscopy.

Purpose of the Study:

  • To quantify and compare aerosol generation during flexible and rigid bronchoscopy.
  • To identify specific phases within bronchoscopy procedures that produce the highest aerosol concentrations.
  • To inform safety protocols for healthcare workers during aerosol-generating procedures.

Main Methods:

  • Continuous measurement of inhalable mass concentration of aerosol generated during bronchoscopy.
  • Comparison of aerosol concentration with baseline readings in the endoscopy room.
  • Inclusion of flexible bronchoscopy (moderate sedation/general anesthesia via ET tube) and rigid bronchoscopy (general anesthesia with jet ventilation).

Main Results:

  • Flexible bronchoscopy under moderate sedation showed significantly higher aerosol levels during lidocaine atomization (P=0.036).
  • Flexible bronchoscopy via endotracheal tube under general anesthesia (GA) had significantly higher aerosol levels during intubation and extubation (P<0.001).
  • Rigid bronchoscopy under GA with jet ventilation demonstrated significantly higher aerosol levels during both the procedure (P=0.01) and recovery (P=0.012).

Conclusions:

  • All phases of bronchoscopy generate elevated aerosol levels, increasing exposure risk.
  • Specific actions like lidocaine atomization, intubation, extubation, and recovery phases are associated with the highest aerosol generation.
  • Findings highlight critical periods for enhanced protective measures during bronchoscopy to mitigate healthcare worker exposure to airborne pathogens.