Department of Respiratory Therapy, Chang Gung University, Taoyuan, Taiwan.
Department of Respiratory Therapy, University of Virginia Medical Center, Charlottesville, Virginia.
Respir Care. 2023 Nov;68(11):1510-1518. doi: 10.4187/respcare.10578. Epub 2023 Jun 6.
Secondhand exposure to fugitive aerosols may cause airway diseases in health providers. We hypothesized that redesigning aerosol masks to be closed-featured would reduce the fugitive aerosol concentrations during nebulization. This study aimed to evaluate the influence of a mask designed for a jet nebulizer on the concentration of fugitive aerosols and delivered doses.
An adult intubation manikin was attached to a lung simulator to mimic normal and distressed adult breathing patterns. The jet nebulizer delivered salbutamol as an aerosol tracer. The nebulizer was attached to 3 aerosol face masks: an aerosol mask, a modified non-rebreathing mask (NRM, with no vent holes), and an AerosoLess mask. An aerosol particle sizer measured aerosol concentrations at parallel distances of 0.8 m and 2.2 m and a frontal distance of 1.8 m from the manikin. The drug dose delivered distal to the manikin's airway was collected, eluted, and analyzed using a spectrophotometer at a 276 nm wavelength.
With a normal breathing pattern, the trends of aerosol concentrations were higher with an NRM followed by an aerosol mask and AerosoLess mask ( < .001) at 0.8 m; however, the concentrations were higher with an aerosol mask followed by NRM and AerosoLess mask at 1.8 m ( < .001) and 2.2 m ( < .001). With a distressed breathing pattern, the aerosol concentrations were higher with an aerosol mask followed by an NRM and AerosoLess mask at 0.8 m, 1.8 m ( < .001), and 2.2 m ( = .005). The delivered drug dose was significantly higher with AerosoLess mask with a normal breathing pattern and with an aerosol mask with a distressed breathing pattern.
Mask design influences fugitive aerosol concentrations in the environment, and a filtered mask reduces the concentration of aerosols at 3 different distances and with 2 breathing patterns.
二手接触逸散性气溶胶可能导致医护人员出现气道疾病。我们假设，将气溶胶口罩设计为封闭式可减少雾化时逸散性气溶胶的浓度。本研究旨在评估一种专为射流雾化器设计的口罩对逸散性气溶胶浓度和输送剂量的影响。
将成人插管模型连接到肺模拟器上，以模拟正常和呼吸困难的成人呼吸模式。射流雾化器将沙丁胺醇作为气溶胶示踪剂输送。雾化器连接到 3 种气溶胶面罩：气溶胶面罩、改良的无重复呼吸面罩（NRM，无通风孔）和 AerosoLess 面罩。气溶胶粒子计数器在距模型 0.8 m、2.2 m 和 1.8 m 的平行距离以及正面距离 1.8 m 处测量气溶胶浓度。在模型气道远端收集、洗脱并使用分光光度计在 276nm 波长下分析输送的药物剂量。
在正常呼吸模式下，NRM 后面跟着气溶胶面罩和 AerosoLess 面罩的气溶胶浓度趋势较高（<0.001），在 0.8 m 处；然而，在 1.8 m（<0.001）和 2.2 m（<0.001）处，气溶胶面罩后面跟着 NRM 和 AerosoLess 面罩的浓度较高。在呼吸困难呼吸模式下，在 0.8 m、1.8 m（<0.001）和 2.2 m（=0.005）处，气溶胶面罩后面跟着 NRM 和 AerosoLess 面罩的气溶胶浓度较高。在正常呼吸模式下，AerosoLess 面罩的输送药物剂量明显高于 NRM 面罩，在呼吸困难呼吸模式下，气溶胶面罩的输送药物剂量明显高于 NRM 面罩。
口罩设计会影响环境中的逸散性气溶胶浓度，而过滤式口罩可降低 3 种不同距离和 2 种呼吸模式下的气溶胶浓度。
