scholarly journals Clinical characterization of respiratory droplet production during common airway procedures using high-speed imaging

2020 ◽  
Author(s):  
SK Mueller ◽  
R Veltrup ◽  
B Jakubaß ◽  
JS Kempfle ◽  
S Kniesburges ◽  
...  
Keyword(s):  
Airway Management ◽  
High Speed ◽  
Clinical Care ◽  
Real Life ◽  
Invasive Ventilation ◽  
High Speed Imaging ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Management Procedures

AbstractBackgroundDuring the COVID-19 pandemic, a significant number of healthcare workers have been infected with SARS-CoV-2. However, there remains little knowledge regarding droplet dissemination during airway management procedures in real life settings.Methods12 different airway management procedures were investigated during routine clinical care. A high-speed video camera (1000 frames/second) was for imaging. Quantitative droplet characteristics as size, distance traveled, and velocity were computed.ResultsDroplets were detected in 8/12 procedures. The droplet trajectories could be divided into two distinctive patterns (type 1/2). Type 1 represented a ballistic trajectory with higher speed droplets whereas type 2 represented a random trajectory of slower particles that persisted longer in air. Speaking and coughing lead to a larger amount of droplets than non-invasive ventilation therapy. The use of tracheal cannula filters reduced the amount of droplets.ConclusionsRespiratory droplet patterns generated during airway management procedures follow two distinctive trajectories based on the influence of aerodynamic forces. Speaking and coughing produce more droplets than non-invasive ventilation therapy confirming these behaviors as exposure risks. Even large droplets may exhibit patterns resembling the fluid dynamics smaller airborne aerosols that follow the airflow convectively and may place the healthcare provider at risk.

scholarly journals Clinical characterization of respiratory large droplet production during common airway procedures using high-speed imaging

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
S. K. Mueller ◽  
R. Veltrup ◽  
B. Jakubaß ◽  
S. Kniesburges ◽  
M. J. Huebner ◽  
...  
Keyword(s):  
Airway Management ◽  
High Speed ◽  
Clinical Care ◽  
Real Life ◽  
Video Camera ◽  
Large Droplet ◽  
High Speed Imaging ◽  
Management Procedures ◽  
Exposure Risks

AbstractDuring the COVID-19 pandemic, a significant number of healthcare workers have been infected with SARS-CoV-2. However, there remains little knowledge regarding large droplet dissemination during airway management procedures in real life settings. 12 different airway management procedures were investigated during routine clinical care. A high-speed video camera (1000 frames/second) was for imaging. Quantitative droplet characteristics as size, distance traveled, and velocity were computed. Droplets were detected in 8/12 procedures. The droplet trajectories could be divided into two distinctive patterns (type 1/2). Type 1 represented a ballistic trajectory with higher speed large droplets whereas type 2 represented a random trajectory of slower particles that persisted longer in air. The use of tracheal cannula filters reduced the amount of droplets. Respiratory droplet patterns generated during airway management procedures follow two distinctive trajectories based on the influence of aerodynamic forces. Speaking and coughing produce more droplets than non-invasive ventilation therapy confirming these behaviors as exposure risks. Even large droplets may exhibit patterns resembling the fluid dynamics smaller airborne aerosols that follow the airflow convectively and may place the healthcare provider at risk.

scholarly journals Defining successful non‐invasive ventilation initiation: Data from a real‐life cohort

Respirology ◽  
2021 ◽  
Author(s):  
Grégoire Jolly ◽  
Léa Razakamanantsoa ◽  
Emeline Fresnel ◽  
Zouhaier Gharsallaoui ◽  
Antoine Cuvelier ◽  
...  
Keyword(s):  
Real Life ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

scholarly journals Use and performance of non-invasive ventilation in Internal Medicine ward: a real-life study

2015 ◽  
Author(s):  
Francesco Ventrella ◽  
Armando Giancola ◽  
Sergio Cappello ◽  
Maria Pipino ◽  
Graziano Minafra ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Real Life ◽  
Invasive Ventilation ◽  
Internal Medicine Ward ◽  
Life Study ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Real Life Study ◽  
And Performance

Respiratory System: Physiology of Mechanical Ventilation

2019 ◽  
Author(s):  
John Yerxa ◽  
Cory J Vatsaas ◽  
Suresh Agarwal
Keyword(s):  
Mechanical Ventilation ◽  
Airway Management ◽  
Critically Ill ◽  
Critically Ill Patient ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Subsequent Chapter ◽  
System Physiology

Airway and ventilatory management are mandatory skills for the critical care surgeon. Identifying and correctly managing a patient’s airway is the first step followed by correcting any oxygenation or ventilation deliver deficits. Mechanical ventilation with positive pressure has multiple physiologic effects that must be completely understood in a complex critically ill patient. Invasive and non-invasive modalities may be used to aid in achieving these goals. Further strategies such as using low tidal volume, adequate PEEP, and rescue strategies are important in patients with ARDS. Weaning from the ventilator as soon as able is an important consideration to improve outcomes,  The subsequent chapter reviews airway management and the physiologic aspects of mechanical ventilation to aid in decision-making when caring for the critically ill patient with deficits in oxygenation or ventilation. This review 5 figures, 2 tables, and 41 references. Key Words: airway management, mechanical ventilation, invasive ventilation, non-invasive ventilation, tracheostomy, Acute Respiratory Distress Syndrome (ARDS), positive pressure ventilation, oxygenation

scholarly journals Remdesivir in Severe COVID-19 and Non-Invasive Ventilation: A Real-Life Experience

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1108
Author(s):  
Francesca Simioli ◽  
Carmine Nicoletta ◽  
Maria Rosaria Valentino ◽  
Maria Martino ◽  
Anna Annunziata ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Antiviral Treatment ◽  
Clinical Signs ◽  
Real Life ◽  
Lung Damage ◽  
Lung Involvement ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Markers Of Inflammation ◽  
Non Invasive Ventilation

Background: Antiviral treatment is a hot topic regarding therapy for COVID-19. Several antiviral drugs have been tested in the months since the pandemic began. Yet only Remdesivir obtained approval after first trials. The best time to administer Remdesivir is still a matter for discussion and this could also depend upon the severity of lung damage and the staging of the infection. Methods: We performed a real-life study of patients hospitalized forCOVID-19 and receiving non-invasive ventilation (NIV). In this single-center study, a 5 day course of Remdesivir was administered as compassionate use. Further therapeutic supports included antibiotics, low molecular weight heparin and steroids. Data collection included clinical signs and symptoms, gas exchange, laboratory markers of inflammation, and radiological findings. Major outcomes were de-escalation of oxygen-support requirements, clinical improvement defined by weaning from ventilation to oxygen therapy or discharge, and mortality. Adverse drug reactions were also recorded. All data were collected during hospitalization and during a 20-day follow up after treatment. Results: 51 patients were enrolled. A global clinical improvement was recorded in 22 patients (43%) at 12 days, and 36 (71%) at 20 days; in particular, at 12 days, 27 patients (53%) also had a de-escalation of oxygen-support class from a therapeutic point of view. Remdesivir use was associated with a lower hazard ratio for clinical improvement in the elderly (older than 70 years) and in subjects with more extensive lung involvement (total severity score at HRCT of more than 14). The 20-day mortality was 13%. Conclusions: Results demonstrated that Remdesivir is associated with an improvement in clinical, laboratory and radiological parameters in patients with severe COVID-19 and showed an overall mortality of 13%. We conclude that, in this cohort, Remdesivir was a beneficial add-on therapy for severe COVID-19, especially in adults with moderate lung involvement at HRCT.

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