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Placing a mask on COVID-19 patients during high-flow nasal cannula therapy reduces aerosol particle dispersion

Jie Li, James B. Fink, Ahmad A. Elshafei, Laurel M. Stewart, Hannah J. Barbian, Sara H. Mirza, Lena Al-Harthi, David Vines, Stephan Ehrmann
ERJ Open Research 2021 7: 00519-2020; DOI: 10.1183/23120541.00519-2020
Jie Li
1Dept of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA
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  • ORCID record for Jie Li
James B. Fink
1Dept of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA
2Aerogen Pharma Corp, San Mateo, CA, USA
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Ahmad A. Elshafei
1Dept of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA
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Laurel M. Stewart
1Dept of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA
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Hannah J. Barbian
3Dept of Microbial Pathogens and Immunity, Rush University, Chicago, IL, USA
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Sara H. Mirza
1Dept of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA
4Dept of Pulmonary and Critical Care, Rush University Medical Center, Chicago, IL, USA
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Lena Al-Harthi
3Dept of Microbial Pathogens and Immunity, Rush University, Chicago, IL, USA
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David Vines
1Dept of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA
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Stephan Ehrmann
5CHRU Tours, Médecine Intensive Réanimation, CIC INSERM 1415, CRICS-TriggerSEP Research Network, Tours, France
6INSERM, Centre d’étude des pathologies respiratoires, U1100, Université de Tours, Tours, France
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    FIGURE 1

    High-flow nasal cannula set-up with a filter cassette with vacuum pump for sampling room air to detect SARS-CoV-2 virus and two optical particle sizers placed longitudinally at 1 foot (30.5 cm) and 3 feet (91.5 cm) away from the patient's face to measure the aerosol concentrations.

Tables

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  • TABLE 1

    Aerosol particle concentrations of different sizes during conventional nasal cannula therapy and high-flow nasal cannula (HFNC) therapy with and without a mask

    Particle sizeConventional nasal cannula# versus HFNC (n=5)HFNC with versus without a mask (n=6)
    Concentration at 1 foot¶Concentration at 3 feet¶Concentration at 1 foot¶Concentration at 3 feet¶
    Conventional cannulaHFNCp-valueConventional cannulaHFNCp-valueNo maskMaskp-valueNo maskMaskp-value
    ≤0.3 µm710 212±622 173581 273± 513 0670.138743 822±658 053570 318± 490 6470.043706 247± 510 591706 611± 531 5850.753653 710± 460 070633 964± 439 6770.249
    0.3–0.5 µm29 598±25 46422 914± 18 3320.68636 511±32 60924 666± 20 4140.0823 020± 17 29721 911± 17 7960.04623 275± 18 72221 802± 17 3070.173
    0.5–1 µm2821±14642744±13170.503966±27582593±12430.0432575±11241980±10830.0282380±11182053±10820.173
    1–3 µm913±368876±4360.345943±499732±3160.043758±348544±2740.028647±295501±2520.028
    3–5 µm436±166418±2420.50423±200355±1790.08386±225266±1170.028319±171254±1240.116
    5–10 µm205±77194±1270.50152±86142±800.225197±177129±650.173135±114107±580.753

    Data are presented as mean±sd. #: conventional nasal cannula therapy was performed at 10–15 L·min−1; ¶: values are indicated in particles per cubic foot. 1 foot=30.5 cm.

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    Placing a mask on COVID-19 patients during high-flow nasal cannula therapy reduces aerosol particle dispersion
    Jie Li, James B. Fink, Ahmad A. Elshafei, Laurel M. Stewart, Hannah J. Barbian, Sara H. Mirza, Lena Al-Harthi, David Vines, Stephan Ehrmann
    ERJ Open Research Jan 2021, 7 (1) 00519-2020; DOI: 10.1183/23120541.00519-2020

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    Placing a mask on COVID-19 patients during high-flow nasal cannula therapy reduces aerosol particle dispersion
    Jie Li, James B. Fink, Ahmad A. Elshafei, Laurel M. Stewart, Hannah J. Barbian, Sara H. Mirza, Lena Al-Harthi, David Vines, Stephan Ehrmann
    ERJ Open Research Jan 2021, 7 (1) 00519-2020; DOI: 10.1183/23120541.00519-2020
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