PT  - JOURNAL ARTICLE
AU  - Rutger Hebbink
AU  - Judith Elshof
AU  - Steven Wanrooij
AU  - Walter Lette
AU  - Kees Venner
AU  - Marieke Duiverman
AU  - Rob Hagmeijer
TI  - Late Breaking Abstract - Aerodynamic SARS-CoV-2 transport in non-invasive ventilatory support methods: a passive tracer study
AID  - 10.1183/13993003.congress-2020.336
DP  - 2020 Sep 07
TA  - European Respiratory Journal
PG  - 336
VI  - 56
IP  - suppl 64
4099  - http://erj.ersjournals.com/content/56/suppl_64/336.short
4100  - http://erj.ersjournals.com/content/56/suppl_64/336.full
SO  - Eur Respir J2020 Sep 07; 56
AB  - Problem: Non-invasive ventilatory support is used for COVID-19, but little is known about the associated virus transport. This puts healthcare professionals at risk.Background: Patients exhale droplets (‘micro-bullets’) and aerosols (‘floating particles’). Droplets are launched and driven by exhalation jets and their reach depends on droplet-size, jet-strength and jet-orientation. Aerosols, however, stay airborne and viable for hours and can end-up anywhere. The aerodynamics and transport of droplets during various ventilatory support methods should be studied to better understand virus transmission.Method: Visualisation of passive-tracer transport to reveal the aerodynamics of NHF, CPAP, BiPAP and other methods, using the 3D-printed head of a virtually breathing adult man.Results: Jet-extension and -orientation was found to depend on the therapy, settings and leakage. In NHF, a small cannula produced an extensive jet (> 1 meter), while dispersion was more limited for a larger cannula. CPAP/BiPAP may also produce extensive jets due to venting and leakage.Conclusion: Droplet-driven transmission depends on jet-extension and jet-orientation and probably leakage. Aerosol transport is inevitable in non-filtered support methods. Because all therapies showed extensive jet dispersion, further research is needed guiding therapy set-up adjustments depending on actual infectious SARS-CoV-2 spread. FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 336.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).