Department of Anaesthesiology and Pain Medicine, United Christian Hospital, Hong Kong.
Department of Occupational Therapy, United Christian Hospital, Hong Kong.
Anaesthesia. 2020 Aug;75(8):1022-1027. doi: 10.1111/anae.15108. Epub 2020 May 26.
The COVID-19 pandemic has increased the demand for disposable N95 respirators. Re-usable elastomeric respirators may provide a suitable alternative. Proprietary elastomeric respirator filters may become depleted as demand increases. An alternative may be the virus/bacterial filters used in anaesthesia circuits, if they can be adequately fitted onto the elastomeric respirators. In addition, many re-usable elastomeric respirators do not filter exhaled breaths. If used for sterile procedures, this would also require modification. We designed a 3D-printed adaptor that permits elastomeric respirators to interface with anaesthesia circuit filters and created a simple modification to divert exhaled breaths through the filter. We conducted a feasibility study evaluating the performance of our modified elastomeric respirators. A convenience sample of eight volunteers was recruited. Quantitative fit testing, respiratory rate and end-tidal carbon dioxide were recorded during fit testing exercises and after 1 h of wear. All eight volunteers obtained excellent quantitative fit testing throughout the trial. The mean (SD) end-tidal carbon dioxide was 4.5 (0.5) kPa and 4.6 (0.4) kPa at baseline and after 1 h of wear (p = 0.148). The mean (SD) respiratory rate was 17 (4) breaths.min and 17 (3) breaths.min at baseline and after 1 h of wear (p = 0.435). Four out of eight subjects self-reported discomfort; two reported facial pressure, one reported exhalation resistance and one reported transient dizziness on exertion. Re-usable elastomeric respirators to utilise anaesthesia circuit filters through a 3D-printed adaptor may be a potential alternative to disposable N95 respirators during the COVID-19 pandemic.
新型冠状病毒肺炎大流行增加了对一次性 N95 呼吸器的需求。可重复使用的弹性体呼吸器可能是一种合适的替代品。随着需求的增加,专用弹性体呼吸器过滤器可能会耗尽。如果可以将其充分适配到弹性体呼吸器上,麻醉回路中使用的病毒/细菌过滤器可能是一种替代选择。此外,许多可重复使用的弹性体呼吸器无法过滤呼出的空气。如果用于无菌操作,则还需要进行修改。我们设计了一种 3D 打印的转接器,使弹性体呼吸器能够与麻醉回路过滤器配合使用,并创建了一个简单的修改方案,使呼出的空气通过过滤器排出。我们进行了一项可行性研究,评估了我们修改后的弹性体呼吸器的性能。招募了 8 名志愿者进行方便抽样。在适配测试过程中和佩戴 1 小时后,记录定量适配测试、呼吸频率和呼气末二氧化碳。在整个试验过程中,所有 8 名志愿者均获得了良好的定量适配测试结果。基础值和佩戴 1 小时后的呼气末二氧化碳平均值(标准差)分别为 4.5(0.5)kPa 和 4.6(0.4)kPa(p=0.148)。基础值和佩戴 1 小时后的呼吸频率平均值(标准差)分别为 17(4)次.min 和 17(3)次.min(p=0.435)。8 名受试者中有 4 名自述感到不适;2 名报告有面部压力,1 名报告呼气阻力,1 名报告用力时短暂头晕。通过 3D 打印转接器使用麻醉回路过滤器的可重复使用弹性体呼吸器可能是新型冠状病毒肺炎大流行期间替代一次性 N95 呼吸器的一种潜在选择。