Exhaled Air Dispersion Distances During Noninvasive Ventilation via Different Respironics Face Masks
Identifieur interne : 004005 ( Main/Merge ); précédent : 004004; suivant : 004006Exhaled Air Dispersion Distances During Noninvasive Ventilation via Different Respironics Face Masks
Auteurs : David S. Hui [République populaire de Chine] ; Benny K. Chow [République populaire de Chine] ; Susanna S. Ng [République populaire de Chine] ; Leo C. Y. Chu [République populaire de Chine] ; Stephen D. Hall [Australie] ; Tony Gin [République populaire de Chine] ; Joseph J. Y. Sung [République populaire de Chine] ; Matthew T. V. Chan [République populaire de Chine]Source :
- Chest [ 0012-3692 ] ; 2009.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- transmission : Influenza, Human.
- Air, Air Pollution, Indoor, Equipment Design, Exhalation, Humans, Masks, Patient Simulation.
Abstract
As part of our influenza pandemic preparedness, we studied the exhaled air dispersion distances and directions through two different face masks (Respironics; Murrysville, PA) attached to a human-patient simulator (HPS) during noninvasive positive-pressure ventilation (NPPV) in an isolation room with pressure of −5 Pa.
The HPS was positioned at 45° on the bed and programmed to mimic mild lung injury (oxygen consumption, 300 mL/min; lung compliance, 35 mL/cm H2O). Airflow was marked with intrapulmonary smoke for visualization. Inspiratory positive airway pressure (IPAP) started at 10 cm H2O and gradually increased to 18 cm H2O, whereas expiratory pressure was maintained at 4 cm H2O. A leakage jet plume was revealed by a laser light sheet, and images were captured by high definition video. Normalized exhaled air concentration in the plume was estimated from the light scattered by the smoke particles.
As IPAP increased from 10 to 18 cm H2O, the exhaled air of a low normalized concentration through the ComfortFull 2 mask (Respironics) increased from 0.65 to 0.85 m at a direction perpendicular to the head of the HPS along the median sagittal plane. When the IPAP of 10 cm H2O was applied via the Image 3 mask (Respironics) connected to the whisper swivel, the exhaled air dispersed to 0.95 m toward the end of the bed along the median sagittal plane, whereas higher IPAP resulted in wider spread of a higher concentration of smoke.
Substantial exposure to exhaled air occurs within a 1-m region, from patients receiving NPPV via the ComfortFull 2 mask and the Image 3 mask, with more diffuse leakage from the latter, especially at higher IPAP.
Url:
DOI: 10.1378/chest.09-0434
PubMed: 19411297
PubMed Central: 7094372
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Hui</name><affiliation wicri:level="4"><nlm:aff id="aff1">Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, People's Republic of China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Chow, Benny K" sort="Chow, Benny K" uniqKey="Chow B" first="Benny K." last="Chow">Benny K. 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Ng</name><affiliation wicri:level="4"><nlm:aff id="aff1">Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, People's Republic of China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Chu, Leo C Y" sort="Chu, Leo C Y" uniqKey="Chu L" first="Leo C. Y." last="Chu">Leo C. Y. Chu</name><affiliation wicri:level="4"><nlm:aff id="aff3">Institute of Space and Earth Information Science, and the Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Institute of Space and Earth Information Science, and the Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Hall, Stephen D" sort="Hall, Stephen D" uniqKey="Hall S" first="Stephen D." last="Hall">Stephen D. Hall</name><affiliation wicri:level="1"><nlm:aff id="aff4">School of Mechanical Engineering, The University of New South Wales, Sydney, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>School of Mechanical Engineering, The University of New South Wales, Sydney, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Gin, Tony" sort="Gin, Tony" uniqKey="Gin T" first="Tony" last="Gin">Tony Gin</name><affiliation wicri:level="4"><nlm:aff id="aff3">Institute of Space and Earth Information Science, and the Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Institute of Space and Earth Information Science, and the Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Sung, Joseph J Y" sort="Sung, Joseph J Y" uniqKey="Sung J" first="Joseph J. Y." last="Sung">Joseph J. Y. Sung</name><affiliation wicri:level="4"><nlm:aff id="aff1">Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, People's Republic of China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Chan, Matthew T V" sort="Chan, Matthew T V" uniqKey="Chan M" first="Matthew T. V." last="Chan">Matthew T. V. Chan</name><affiliation wicri:level="4"><nlm:aff id="aff3">Institute of Space and Earth Information Science, and the Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Institute of Space and Earth Information Science, and the Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author></analytic><series><title level="j">Chest</title><idno type="ISSN">0012-3692</idno><idno type="eISSN">1931-3543</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Air</term><term>Air Pollution, Indoor</term><term>Equipment Design</term><term>Exhalation</term><term>Humans</term><term>Influenza, Human (transmission)</term><term>Masks</term><term>Patient Simulation</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Air</term><term>Conception d'appareillage</term><term>Expiration</term><term>Grippe humaine (transmission)</term><term>Humains</term><term>Masques</term><term>Pollution de l'air ambiant intérieur</term><term>Simulation sur patients standardisés</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Air</term><term>Air Pollution, Indoor</term><term>Equipment Design</term><term>Exhalation</term><term>Humans</term><term>Masks</term><term>Patient Simulation</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="fr"><term>Air</term><term>Conception d'appareillage</term><term>Expiration</term><term>Grippe humaine</term><term>Humains</term><term>Masques</term><term>Pollution de l'air ambiant intérieur</term><term>Simulation sur patients standardisés</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>As part of our influenza pandemic preparedness, we studied the exhaled air dispersion distances and directions through two different face masks (Respironics; Murrysville, PA) attached to a human-patient simulator (HPS) during noninvasive positive-pressure ventilation (NPPV) in an isolation room with pressure of −5 Pa.</p></sec><sec><title>Methods</title><p>The HPS was positioned at 45° on the bed and programmed to mimic mild lung injury (oxygen consumption, 300 mL/min; lung compliance, 35 mL/cm H<sub>2</sub>O). Airflow was marked with intrapulmonary smoke for visualization. Inspiratory positive airway pressure (IPAP) started at 10 cm H<sub>2</sub>O and gradually increased to 18 cm H<sub>2</sub>O, whereas expiratory pressure was maintained at 4 cm H<sub>2</sub>O. A leakage jet plume was revealed by a laser light sheet, and images were captured by high definition video. Normalized exhaled air concentration in the plume was estimated from the light scattered by the smoke particles.</p></sec><sec><title>Findings</title><p>As IPAP increased from 10 to 18 cm H<sub>2</sub>O, the exhaled air of a low normalized concentration through the ComfortFull 2 mask (Respironics) increased from 0.65 to 0.85 m at a direction perpendicular to the head of the HPS along the median sagittal plane. When the IPAP of 10 cm H<sub>2</sub>O was applied via the Image 3 mask (Respironics) connected to the whisper swivel, the exhaled air dispersed to 0.95 m toward the end of the bed along the median sagittal plane, whereas higher IPAP resulted in wider spread of a higher concentration of smoke.</p></sec><sec><title>Conclusions</title><p>Substantial exposure to exhaled air occurs within a 1-m region, from patients receiving NPPV via the ComfortFull 2 mask and the Image 3 mask, with more diffuse leakage from the latter, especially at higher IPAP.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Yuen, Ky" uniqKey="Yuen K">KY Yuen</name></author><author><name sortKey="Chan, Pk" uniqKey="Chan P">PK Chan</name></author><author><name sortKey="Peiris, M" uniqKey="Peiris M">M Peiris</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abdel Ghafar, An" uniqKey="Abdel Ghafar A">AN 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Tsoi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Li, Y" uniqKey="Li Y">Y Li</name></author><author><name sortKey="Leung, Gm" uniqKey="Leung G">GM Leung</name></author><author><name sortKey="Tang, Jw" uniqKey="Tang J">JW Tang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wong, Rs" uniqKey="Wong R">RS Wong</name></author><author><name sortKey="Hui, Ds" uniqKey="Hui D">DS Hui</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="World Health Organization" uniqKey="World Health Organization">World Health Organization</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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