Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross, Bangkok, Thailand.
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Thai Red Cross Emerging Infectious Diseases Clinical Center, King Chulalongkorn Memorial Hospital and Chulalongkorn University, Bangkok, Thailand.
J Gastroenterol Hepatol. 2021 Jul;36(7):1913-1919. doi: 10.1111/jgh.15416. Epub 2021 Feb 18.
During the Coronavirus Disease 2019 pandemic, esophagogastroduodenoscopy (EGD) has been recognized as an aerosol-generating procedure. This study aimed to systematically compare the degree of face shield contamination between endoscopists who performed EGD on patients lying in the left lateral decubitus (LL) and prone positions.
This is a randomized trial in patients scheduled for EGD between April and June 2020. Eligible 212 patients were randomized with 1:1 allocation. Rapid adenosine triphosphate test was used to determine contamination level using relative light units of greater than 200 as a cutoff value. All eligible patients were randomized to lie in either the LL or prone position during EGD. The primary outcome was the rate of contamination on the endoscopist's face shield.
The majority of patients were female (63%), with a mean age of 60 ± 13 years. Baseline characteristics were comparable between the two groups. There was no face shield contamination after EGD in either group. The number of coughs in the LL group was higher than the prone group (1.38 ± 1.8 vs 0.89 ± 1.4, P = 0.03). The mean differences in relative light units on the face shield before and after EGD in the LL and prone groups were 9.9 ± 20.9 and 4.1 ± 6 (P = 0.008), respectively.
As measured by the adenosine triphosphate test, performing diagnostic EGD does not lead to contamination on the face shield of the endoscopist. However, placing patients in the prone position may further mitigate the risk.
在 2019 年冠状病毒病大流行期间，食管胃十二指肠镜检查（EGD）已被认为是一种产生气溶胶的操作。本研究旨在系统比较左侧卧位（LL）和俯卧位行 EGD 的内镜医师的护目镜污染程度。
这是一项在 2020 年 4 月至 6 月期间行 EGD 的患者中进行的随机试验。符合条件的 212 名患者以 1:1 的比例随机分配。使用相对光单位大于 200 作为截止值的快速三磷酸腺苷试验来确定污染程度。所有符合条件的患者在 EGD 期间随机处于 LL 或俯卧位。主要结局是内镜医师护目镜的污染率。
大多数患者为女性（63%），平均年龄为 60±13 岁。两组的基线特征相似。两组在 EGD 后均未出现护目镜污染。LL 组的咳嗽次数高于俯卧组（1.38±1.8 次比 0.89±1.4 次，P=0.03）。LL 组和俯卧组 EGD 前后护目镜相对光单位的平均差值分别为 9.9±20.9 和 4.1±6（P=0.008）。
根据三磷酸腺苷试验测量，行诊断性 EGD 不会导致内镜医师护目镜污染。然而，将患者置于俯卧位可能会进一步降低风险。
