Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL.
Division of Cardiovascular Disease, Mayo Clinic, Jacksonville, FL.
Chest. 2021 Aug;160(2):633-641. doi: 10.1016/j.chest.2021.02.045. Epub 2021 Mar 2.
The clinical benefits of cardiopulmonary rehabilitation are extensive, including improvements in health-related quality of life, emotional condition, physical function, and overall mortality. The COVID-19 pandemic continues to have a negative impact on center-based cardiopulmonary rehabilitation. Justifiable concern exists that the exercise-related increase in pulmonary ventilation within the rehabilitation classes may lead to the generation of infectious respiratory particles.
Is cardiopulmonary rehabilitation while wearing a procedural mask a particle-generating procedure?
Data were collected prospectively at a cardiopulmonary rehabilitation facility with all patients wearing a procedural mask. Small (0.3-4.9 μm) and large (5-10 μm) particle generation was quantified using a light-scattering particle counter. Data were analyzed by time, exertion level, and number of participants.
A total of 24 distinct patients attended two or more of the cardiopulmonary rehabilitation classes tested. Most of the patients were men (n = 16 [67%]) and were in rehabilitation because of cardiac disease. During the cardiopulmonary rehabilitation class, small and large micrometer-size particles increased with increasing class size. In classes with four patients or more, a significant increase was found from ambient levels in both small (four patients, P < .01; and five patients, P < .01) and large (four patients, P < .01; and five patients, P < .01) particle count that peaked at about 35 to 40 min during each class.
Using an airborne particle counter, we found significant exercise-related increases in both small and large micrometer-size particle generation during cardiopulmonary rehabilitation classes, with larger class sizes (ie, more patients), despite participants wearing a procedural mask.
心肺康复的临床益处广泛，包括改善健康相关生活质量、情绪状况、身体功能和总体死亡率。COVID-19 大流行继续对以中心为基础的心肺康复产生负面影响。有合理的担忧认为，康复课程中与运动相关的肺通气增加可能导致传染性呼吸颗粒的产生。
心肺康复时佩戴手术口罩是否会产生颗粒？
数据在一家心肺康复机构前瞻性收集，所有患者均佩戴手术口罩。使用光散射粒子计数器定量测量小（0.3-4.9μm）和大（5-10μm）颗粒的生成。通过时间、用力水平和参与者数量分析数据。
共有 24 名不同的患者参加了两个或更多心肺康复课程的测试。大多数患者为男性（n=16 [67%]），因心脏疾病接受康复治疗。在心肺康复课程中，随着课程规模的增加，小和大微米大小的颗粒会增加。在有四名或更多患者的课程中，从小（四名患者，P<.01；五名患者，P<.01）和大（四名患者，P<.01；五名患者，P<.01）颗粒计数来看，都发现与环境水平相比，颗粒计数显著增加，且每个课程中大约在 35 到 40 分钟达到峰值。
使用空气传播颗粒计数器，我们发现心肺康复课程中，尽管参与者佩戴了手术口罩，但与运动相关的小和大微米大小的颗粒生成显著增加，且课程规模越大（即患者越多）。
