Design and quantitative evaluation of ‘Aerosol Bio-Containment Device (ABCD)’ for reducing aerosol exposure during infectious aerosol-generating events

Waring, Michael S.; Lo, L. James; Kohanski, Michael A.; Kahle, Elizabeth R.; Marcus, Ian M.; Smith, Heather; Spiller, Kara L.; Walker, Sharon L.

doi:10.1371/journal.pone.0272716

Cited by 1 publication

(4 citation statements)

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“…First pass intubation was also completed 91% of the time with the ABCD compared with 75% and 83% with the previously described devices [10] . These differences could be due to the design of the arm port placement and larger diameter ports of the ABCD [23] .…”

Section: Adverse Event # Eventsmentioning

confidence: 99%

“…Users also reported that the device impaired motion and increased the overall workflow burden associated with caring for the patient. The measured and modeled effectiveness of the ABCD in reducing aerosol exposure is dependent on maintaining high quality device seals at access points and adequate evacuation of air from within the device [23] . The trade-offs with use of an aerosol protective device to effectively seal off and evacuate aerosols include the decreased access to the patient and increased technical complexity during high acuity medical procedures such as intubation of a patient in respiratory distress.…”

Section: Adverse Event # Eventsmentioning

confidence: 99%

“…The ABCD also has a suction port on top that connects to standard 1/4 inch suction tubing. The device has undergone rigorous aerosol containment and evacuation testing [23] .…”

Section: Device Designmentioning

confidence: 99%

“…An aerosol biocontainment device (ABCD) was designed and built to contain and remove droplet and aerosols. The ABCD underwent rigorous efficiency testing under laboratory conditions as well as assessment through computational fluid dynamic simulated scenarios, and the ABCD demonstrated a robust capability to control aerosol exposure with maintenance of device seals and appropriate use of suction [23] . Here we investigated use of the ABCD for intubation in patients undergoing procedures requiring intubation in an operating room setting.…”

mentioning

confidence: 99%

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Randomized controlled trial assessing intubation time with and without an aerosol biocontainment device

Kohanski¹,

Ungerer²,

Xu³

et al. 2023

JOHNA

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Introduction:The emergence of the coronavirus disease 2019 (COVID-19) pandemic renewed interest in infectious aerosols and methods to reduce risk of airborne respiratory pathogen transmission. This has led to the development of novel aerosol protective devices for which clinical and aerosol protective features have not been fully characterized. The relative efficacy of these devices for use during airway procedures has not been assessed in randomized controlled trials. Materials and Methods: We recruited anesthesiology attendings, residents, and certified registered nurse anesthetists to perform intubations with an aerosol biocontainment device (ABCD). Thirty-seven patients undergoing procedures requiring intubation in the operating room were recruited and randomized (2:1) to intubation with (25) or without (12) the ABCD. Primary endpoints were time to secure the airway and adverse events. Secondary endpoints were a number of intubation attempts, access to the patient and airway equipment through the device ports, user assessment of ABCD function and technical burden, and patient experience in the ABCD. Results: Intubation time with the ABCD (46 s) was not significantly different compared to intubation without the ABCD (37 s; P = 0.06). There were 3 adverse events with the ABCD (1 claustrophobia, 2 unanticipated difficult airways) that required device removal for intubation. In general, patients tolerated the device well and ABCD users felt the device functioned as intended but increased the technical burden associated with intubation. Discussion: It is feasible to use an aerosol protective device for intubation. The introduction of novel devices into high acuity airway procedures should be approached with caution and should account for the risk mitigation gained from the device balanced against the increased procedural complexity and potential safety risks associated with restricted access to the airway.

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Section: Adverse Event # Eventsmentioning

confidence: 99%

Section: Adverse Event # Eventsmentioning

confidence: 99%

“…The ABCD also has a suction port on top that connects to standard 1/4 inch suction tubing. The device has undergone rigorous aerosol containment and evacuation testing [23] .…”

Section: Device Designmentioning

confidence: 99%

mentioning

confidence: 99%

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