雾化吸入与计量吸入器的使用对 COVID-19 患者体内病毒颗粒弥散的影响

IF 0.9 Q4 INFECTIOUS DISEASES
Brian M Clemency, Candice Clay, Renoj Varughese, Carli Kennedy, Wayne Yates, Asma Lat, Ai Ling Ching, Doug Clark, David Lewin, Xianyi Chen, Mario Castro
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引用次数: 0

摘要

关于雾化吸入作为气溶胶产生程序的特性以及随后将 SARS-CoV-2 传播给医护人员的风险,存在着相互矛盾的指导意见。本研究旨在探讨通过雾化器和计量吸入器 (MDI) 给药的支气管扩张剂是否会影响 SARS-CoV-2 病毒载量的分布。感染了 COVID-19 的成人被纳入研究,并以随机交叉的顺序接受了单剂量硫酸阿布特罗雾化溶液(2.5 毫克/3 毫升,通过带过滤口罩的呼吸驱动式雾化器)或硫酸氢氟烷烃阿布特罗吸入气雾剂(90 微克/作用剂量;通过带间隔器的计量吸入器吸入两口)。在患者病房内的预定位置对空气和表面进行采样,以评估 SARS-CoV-2 在三个时期(基线期、MDI 期和雾化期)的扩散情况。11 名患者接受了交叉治疗。有六名患者在一个治疗阶段(MDI 和雾化治疗阶段各为 3 人)检测到了 SARS-CoV-2 RNA,有一名患者在两个治疗阶段都检测到了 SARS-CoV-2 RNA。四名患者(36.4%)的房间未发现病毒 RNA。总体而言,很少有环境样本(17/397;4.3%)含有可检测到的病毒 RNA,不同时期的阳性率没有明显差异;阳性样本的 RNA 基因组拷贝数较低。没有观察到分散与患者临床状态或环境参数之间的相关性。在这项首次评估 COVID-19 住院患者使用雾化器和 MDI 后病毒载量分布情况的前瞻性试验中,无论采用哪种给药方法,环境污染都很低。研究结果支持在治疗 COVID-19 患者时使用其中一种设备。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of nebulization versus metered-dose inhaler utilization on viral particle dispersion in patients with COVID-19
Conflicting guidance exists regarding the characterization of nebulization as an aerosol-generating procedure and subsequent risk of transmission of SARS-CoV-2 to healthcare workers. This study sought to address whether SARS-CoV-2 viral load distribution was impacted by bronchodilator delivery via nebulizer versus metered-dose inhaler (MDI). Adults infected with COVID-19 were enrolled and received a single dose of albuterol sulfate nebulized solution (2.5 mg/3 mL via breath-actuated nebulizer with filtered mouthpiece) or albuterol sulfate hydrofluoroalkane inhalation aerosol (90 µg/actuation; two puffs via MDI with spacer) in a randomized crossover sequence. Air and surfaces were sampled at predefined locations within patients’ hospital rooms to assess SARS-CoV-2 dispersion over three periods (baseline, MDI, and nebulizer). Eleven patients received crossover therapy. Six patients had detectable SARS-CoV-2 RNA during one treatment period ( n = 3 each for MDI and nebulizer) and one during both treatment periods. No viral RNA was found in the rooms of four (36.4%) patients. Overall, few environmental samples (17/397; 4.3%) contained detectable viral RNA, with no meaningful differences in positivity rate across periods; RNA genome copy numbers were low in positive samples. No correlation between dispersion and patient clinical status or environmental parameters was observed. In this first prospective trial evaluating viral load distribution following use of nebulizer versus MDI in hospitalized patients with COVID-19, low environmental contamination was found regardless of administration method. Findings support the use of either device when needed to treat patients with COVID-19.
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来源期刊
Journal of Infection Prevention
Journal of Infection Prevention Nursing-Advanced and Specialized Nursing
CiteScore
1.70
自引率
8.30%
发文量
46
期刊介绍: Journal of Infection Prevention is the professional publication of the Infection Prevention Society. The aim of the journal is to advance the evidence base in infection prevention and control, and to provide a publishing platform for all health professionals interested in this field of practice. Journal of Infection Prevention is a bi-monthly peer-reviewed publication containing a wide range of articles: ·Original primary research studies ·Qualitative and quantitative studies ·Reviews of the evidence on various topics ·Practice development project reports ·Guidelines for practice ·Case studies ·Overviews of infectious diseases and their causative organisms ·Audit and surveillance studies/projects
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