Bronchoscopy safety precautions for diagnosing COVID-19 associated pulmonary aspergillosis—A simulation study

Bronchoscopy safety precautions for diagnosing COVID-19 associated pulmonary aspergillosis—A simulation study

Author:

Philipp KoehlerOliver A Cornely, Matthias Kochanek

Date: 26 September 2020

Abstract:

Objectives: With the outbreak of coronavirus disease 2019 (COVID-19), clinicians have used personal protective equipment to avoid transmission of severe acute respiratory syndrome coronavirus 2. However, they still face occupational risk of infection, when treating COVID-19 patients. This may be highest during invasive diagnostic procedures releasing aerosols and droplets. Thereby, the use of diagnostic procedures for Covid-19 associated aspergillosis may be delayed or impeded, as use of bronchoscopy has been discouraged. This leads to avoidance of a crucial procedure for diagnosing invasive aspergillosis. We intent to visualise aerosol and droplet spread and surface contamination during bronchoscopy and address which measures can avoid exposure of health-care workers.

Methods: We created a simulation model to visualise aerosol and droplet generation as well as surface contamination by nebulising fluorescent solution detected by using ultraviolet light- and slow-motion capture. We repurposed covers for ultrasound transducers or endoscopic cameras to prevent surface and ambient air contamination.

Results: In our bronchoscopy simulation model, we noticed extensive aerosol generation, droplet spread and surface contamination. Exposure of health-care workers and contamination of surfaces can be efficiently reduced by repurposing covers for ultrasound transducers or endoscopic cameras to seal the tube opening during bronchoscopy in mechanically ventilated patients.

Conclusion: Adequate personal protective equipment and safety strategies allow to minimise contamination during bronchoscopy in mechanically ventilated COVID-19 patients.

Keywords: Coronavirus; SARS-CoV-2; contamination; health-care workers; nosocomial infection.

Link to DOI

Download the full article (Disclaimer)

This manuscript library of ~16,000 articles (1729-2024) related to Aspergillus and aspergillosis is intended for individual study only, and is provided as contribution to global understanding of the topic. Please refer to the publisher’s guidance about any other usage.