Droplet nuclei are generated during colonoscopy and are decreased by the use of carbon dioxide and water immersion technique
Publication in refereed journal
香港中文大學研究人員
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替代計量分析
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摘要Objectives
The COVID-19 pandemic has raised concerns on whether colonoscopies (CS) carry a transmission risk. The aim was to determine whether CS are aerosol-generating procedures.
Methods
This was a prospective observational trial including all patients undergoing CS at the Prince of Wales Hospital from 1 June to 31 July 2020. Three particle counters were placed 10 cm from each patient’s anus and near the mouth of endoscopists and nurses. The particle counter recorded the number of particles of size 0.3, 0.5, 0.7, 1, 5, and 10 μm. Patient demographics, seniority of endoscopists, use of CO2 and water immersion technique, and air particle count (particles/cubic foot, dCF) were recorded. Multilevel modeling was used to test all the hypotheses with a post-hoc analysis.
Results
A total of 117 patients were recruited. During CS, the level of 5 μm and 10 μm were significantly higher than the baseline period (P = 0.002). Procedures performed by trainees had a higher level of aerosols when compared to specialists (0.3 μm, P < 0.001; 0.5 μm and 0.7 μm, P < 0.001). The use of CO2 and water immersion techniques had significantly lower aerosols generated when compared to air (CO2: 0.3, 0.5, and 0.7 μm: P < 0.001; water immersion: 0.3 μm: P = 0.048; 0.7 μm: P = 0.03). There were no significant increases in any particle sizes during the procedure at the endoscopists' and nurses' mouth. However, 8/117 (6.83%) particle count tracings showed a simultaneous surge of all particle sizes at the patient's anus and endoscopists' and nurses' level during rectal extubation.
Conclusion
Colonoscopy generates droplet nuclei especially during rectal extubation. The use of CO2 and water immersion techniques may mitigate these risks.
The COVID-19 pandemic has raised concerns on whether colonoscopies (CS) carry a transmission risk. The aim was to determine whether CS are aerosol-generating procedures.
Methods
This was a prospective observational trial including all patients undergoing CS at the Prince of Wales Hospital from 1 June to 31 July 2020. Three particle counters were placed 10 cm from each patient’s anus and near the mouth of endoscopists and nurses. The particle counter recorded the number of particles of size 0.3, 0.5, 0.7, 1, 5, and 10 μm. Patient demographics, seniority of endoscopists, use of CO2 and water immersion technique, and air particle count (particles/cubic foot, dCF) were recorded. Multilevel modeling was used to test all the hypotheses with a post-hoc analysis.
Results
A total of 117 patients were recruited. During CS, the level of 5 μm and 10 μm were significantly higher than the baseline period (P = 0.002). Procedures performed by trainees had a higher level of aerosols when compared to specialists (0.3 μm, P < 0.001; 0.5 μm and 0.7 μm, P < 0.001). The use of CO2 and water immersion techniques had significantly lower aerosols generated when compared to air (CO2: 0.3, 0.5, and 0.7 μm: P < 0.001; water immersion: 0.3 μm: P = 0.048; 0.7 μm: P = 0.03). There were no significant increases in any particle sizes during the procedure at the endoscopists' and nurses' mouth. However, 8/117 (6.83%) particle count tracings showed a simultaneous surge of all particle sizes at the patient's anus and endoscopists' and nurses' level during rectal extubation.
Conclusion
Colonoscopy generates droplet nuclei especially during rectal extubation. The use of CO2 and water immersion techniques may mitigate these risks.
出版社接受日期23.06.2022
著者Shannon Melissa Chan, Tsz Wah Ma, Simon Chu, Hon Sok Fei, Kaori Futaba, Hon Chi Yip, Anthony Yuen Bun Teoh, Martin Chi Sang Wong, Simon Siu Man Ng, Enders Kwok Wai Ng, Philip Wai Yan Chiu
期刊名稱Digestive Endoscopy
出版年份2023
月份1
卷號35
期次1
出版社Wiley
頁次77 - 85
國際標準期刊號0915-5635
語言英式英語
