Hui David S, Chow Benny K, Chu Leo C Y, Ng Susanna S, Hall Stephen D, Gin Tony, Chan Matthew T V
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, The University of New South Wales, Australia.
Center for Housing Innovations, Institute of Space and Earth Information Science, The Chinese University of Hong Kong, The University of New South Wales, Australia.
Chest. 2009 Mar;135(3):648-654. doi: 10.1378/chest.08-1998.
As part of our influenza pandemic preparedness, we studied the dispersion distances of exhaled air and aerosolized droplets during application of a jet nebulizer to a human patient simulator (HPS) programmed at normal lung condition and different severities of lung injury.
The experiments were conducted in a hospital isolation room with a pressure of - 5 Pa. Airflow was marked with intrapulmonary smoke. The jet nebulizer was driven by air at a constant flow rate of 6 L/min, with the mask reservoir filled with sterile water and attached to the HPS via a nebulizer mask. The exhaled leakage jet plume was revealed by a laser light sheet and images captured by high-definition video. Smoke concentration in the plume was estimated from the light scattered by smoke and droplet particles.
The maximum dispersion distance of smoke particles through the nebulizer side vent was 0.45 m lateral to the HPS at normal lung condition (oxygen consumption, 200 mL/min; lung compliance, 70 mL/cm H(2)O), but it increased to 0.54 m in mild lung injury (oxygen consumption, 300 mL/min; lung compliance, 35 mL/cm H(2)O), and beyond 0.8 m in severe lung injury (oxygen consumption, 500 mL/min; lung compliance, 10 mL/cm H(2)O). More extensive leakage through the side vents of the nebulizer mask was noted with more severe lung injury.
Health-care workers should take extra protective precaution within at least 0.8 m from patients with febrile respiratory illness of unknown etiology receiving treatment via a jet nebulizer even in an isolation room with negative pressure.
作为我们流感大流行防范工作的一部分，我们研究了在将喷射雾化器应用于模拟正常肺部状况及不同严重程度肺损伤的人体患者模拟器（HPS）时，呼出空气和气溶胶飞沫的扩散距离。
实验在一间压力为 -5 帕的医院隔离病房内进行。通过肺内烟雾标记气流。喷射雾化器由流速恒定为 6 升/分钟的空气驱动，面罩储液器装满无菌水，并通过雾化器面罩连接到 HPS。呼出的泄漏喷射羽流由激光片显示，并由高清视频捕获图像。羽流中的烟雾浓度通过烟雾和液滴颗粒散射的光来估算。
在正常肺部状况下（耗氧量 200 毫升/分钟；肺顺应性 70 毫升/厘米水柱），通过雾化器侧孔的烟雾颗粒最大扩散距离在 HPS 侧面为 0.45 米，但在轻度肺损伤时（耗氧量 300 毫升/分钟；肺顺应性 35 毫升/厘米水柱）增加到 0.54 米，在重度肺损伤时（耗氧量 500 毫升/分钟；肺顺应性 10 毫升/厘米水柱）超过 0.8 米。肺损伤越严重，通过雾化器面罩侧孔的泄漏越广泛。
即使在负压隔离病房中，医护人员对病因不明的发热呼吸道疾病患者通过喷射雾化器进行治疗时，也应在至少 0.8 米范围内采取额外的防护措施。
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