Aerosol generation from the respiratory tract with various modes of oxygen delivery

Nathaniel T. Gaeckle, Jihyeon Lee, Yensil Park, Gean Kreykes, Michael D. Evans, Christopher J. Hogan

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Rationale: Aerosol generation with modes of oxygen therapy such as high-flow nasal cannula and noninvasive positive-pressure ventilation is a concern for healthcare workers during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The amount of aerosol generation from the respiratory tract with these various oxygen modalities is unknown. Objectives: To measure the size and number concentration of particles and droplets generated from the respiratory tract of humans exposed to various oxygen delivery modalities. Methods: Ten healthy participants with no active pulmonary disease were enrolled. Oxygen modalities tested included nonhumidified nasal cannula, face mask, heated and humidified high-flow nasal cannula, and noninvasive positive-pressure ventilation. Aerosol generation was measured with each oxygen mode while participants performed maneuvers of normal breathing, talking, deep breathing, and coughing. Testing was conducted in a negative-pressure room. Particles with a diameter between 0.37 and 20 μm were measured using an aerodynamic particle spectrometer. Measurements and Main Results: Median particle concentration ranged from 0.041 to 0.168 particles/cm3. Median diameter ranged from 1.01 to 1.53 μm. Cough significantly increased the number of particles measured. Measured aerosol concentration did not significantly increase with the use of either humidified high-flow nasal cannula or noninvasive positive-pressure ventilation. This was the case during normal breathing, talking, deep breathing, and coughing. Conclusions: Oxygen delivery modalities of humidified high-flow nasal cannula and noninvasive positive-pressure ventilation do not increase aerosol generation from the respiratory tract in healthy human participants with no active pulmonary disease measured in a negative-pressure room.

Original languageEnglish (US)
Pages (from-to)1115-1124
Number of pages10
JournalAmerican journal of respiratory and critical care medicine
Volume208
Issue number8
DOIs
StatePublished - Oct 15 2020

Bibliographical note

Funding Information:
Supported by a rapid COVID grant from the Office of Academic and Clinical Affairs at the University of Minnesota (N.T.G.) and by the NIH’s National Center for Advancing Translational Sciences, grant UL1TR002494 (M.D.E.). The content is solely the responsibility of the author and does not necessarily represent the official views of the NIH’s National Center for Advancing Translational Sciences.

Keywords

  • Droplet
  • Particle
  • SARS-CoV-2

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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