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通过大呼吸道飞沫在言语过程中在呼吸道内的沉积特征追踪其来源。

Tracing the origin of large respiratory droplets by their deposition characteristics inside the respiratory tract during speech.

作者信息

Wang Yihan, Wei Jianjian, Gao Caroline X, Jin Tao, Liu Li

机构信息

Institute of Refrigeration and Cryogenics, Key Laboratory of Refrigeration and Cryogenic Technology of Zhejiang Province, Zhejiang University, Hangzhou, 310000 China.

Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia.

出版信息

Build Simul. 2023;16(5):781-794. doi: 10.1007/s12273-022-0982-0. Epub 2023 Mar 13.

Abstract

Origin of differently sized respiratory droplets is fundamental for clarifying their viral loads and the sequential transmission mechanism of SARS-CoV-2 in indoor environments. Transient talking activities characterized by low (0.2 L/s), medium (0.9 L/s), and high (1.6 L/s) airflow rates of monosyllabic and successive syllabic vocalizations were investigated by computational fluid dynamics (CFD) simulations based on a real human airway model. SST model was chosen to predict the airflow field, and the discrete phase model (DPM) was used to calculate the trajectories of droplets within the respiratory tract. The results showed that flow field in the respiratory tract during speech is characterized by a significant laryngeal jet, and bronchi, larynx, and pharynx-larynx junction were main deposition sites for droplets released from the lower respiratory tract or around the vocal cords, and among which, over 90% of droplets over 5 µm released from vocal cords deposited at the larynx and pharynx-larynx junction. Generally, droplets' deposition fraction increased with their size, and the maximum size of droplets that were able to escape into external environment decreased with the airflow rate. This threshold size for droplets released from the vocal folds was 10-20 µm, while that for droplets released from the bronchi was 5-20 µm under various airflow rates. Besides, successive syllables pronounced at low airflow rates promoted the escape of small droplets, but do not significantly affect the droplet threshold diameter. This study indicates that droplets larger than 20 µm may entirely originate from the oral cavity, where viral loads are lower; it provides a reference for evaluating the relative importance of large-droplet spray and airborne transmission route of COVID-19 and other respiratory infections.

摘要

不同大小呼吸道飞沫的来源对于阐明其病毒载量以及严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在室内环境中的连续传播机制至关重要。基于真实人体气道模型,通过计算流体动力学(CFD)模拟研究了以单音节和连续音节发声的低(0.2升/秒)、中(0.9升/秒)和高(1.6升/秒)气流速率为特征的瞬态说话活动。选择剪切应力输运(SST)模型来预测气流场,并使用离散相模型(DPM)计算呼吸道内飞沫的轨迹。结果表明,说话时呼吸道内的流场以显著的喉喷流为特征,支气管、喉部和咽喉交界处是下呼吸道或声带周围释放的飞沫的主要沉积部位,其中,从声带释放的直径超过5微米的飞沫中,超过90%沉积在喉部和咽喉交界处。一般来说,飞沫的沉积分数随其大小增加,能够逸出到外部环境中的飞沫的最大尺寸随气流速率降低。在各种气流速率下,从声带释放的飞沫的这个临界尺寸为10-20微米,而从支气管释放的飞沫的临界尺寸为5-20微米。此外,在低气流速率下发出的连续音节促进了小飞沫的逸出,但对飞沫临界直径没有显著影响。本研究表明,大于20微米的飞沫可能完全源自口腔,口腔中的病毒载量较低;它为评估2019冠状病毒病和其他呼吸道感染的大飞沫喷雾和空气传播途径的相对重要性提供了参考。

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