Published In

The Journal of Hospital Infection

Document Type

Pre-Print

Publication Date

4-14-2021

Subjects

Carbon dioxide -- Environmental aspects, Indoor air quality

Abstract

Background High flow nasal cannula therapy (HFNC) may increase aerosol generation, putting healthcare workers at risk, including from SARS-CoV-2. Aim This study examined whether use of HFNC increases near-field aerosols and if there is a relationship with flow rate. Methods Subjects aged four weeks to 24 months were recruited. Each child received HFNC therapy at different flow rates. Three stations with particle counters were deployed to measure particle concentrations and dispersion in the room: station one within 0.5 m, station two at 2 m, and station three on the other side of the room. We measured carbon dioxide (CO2) and relative humidity. Far-field measurements were used to adjust the near-field measurements. Findings We enrolled ten children ranging from 6-23 months (median 9 months). Elevated CO2 indicated the near-field measurements were in the breathing plane. Near-field breathing plane concentrations of aerosols with diameter 0.3 – 10 μm are elevated by the presence of the patient with no HFNC flow, relative to the room far-field, by 0.45 #/cm3. While we observed variability between subjects in their emission and dispersion of particles, we did not find an association between HFNC use, at any flowrate, and near-field particle counts. Conclusion This method of particle sampling is feasible in hospital settings; correcting the near-patient aerosol and CO2 levels for the room far-field may provide proxies of exposure risk to pathogens generated. In this pilot, near-patient levels of particles with a diameter between 0.3-10 μm and CO2 were not affected by the use of HFNC.

Rights

Copyright © 2021 Elsevier Inc

Description

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

DOI

10.1016/j.jhin.2021.04.002

Persistent Identifier

https://archives.pdx.edu/ds/psu/35292

Included in

Biology Commons

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