Mitigating exhalation puffs during oxygen therapy for respiratory disease

Published on Aug 5, 2021in Physics of Fluids3.514
· DOI :10.1063/5.0057227
Arshad Kudrolli38
Estimated H-index: 38
(Clark University),
Brian Chang5
Estimated H-index: 5
(Clark University)
+ 5 AuthorsWilliam McGee18
Estimated H-index: 18
(UMMS: University of Massachusetts Medical School)
We investigate the dispersal of exhalations corresponding to a patient experiencing shortness of breath while being treated for a respiratory disease with oxygen therapy. Respiration through a nasal cannula and a simple O2 mask is studied using a supine manikin equipped with a controllable mechanical lung by measuring aerosol density and flow with direct imaging. Exhalation puffs are observed to travel 0.35 ± 0.02 m upward while wearing a nasal cannula, and 0.29 ± 0.02 m laterally through a simple O2 mask, posing a higher direct exposure risk to caregivers. The aerosol-laden air flows were found to concentrate in narrow conical regions through both devices at several times their concentration level compared with a uniform spreading at the same distance. We test a mitigation strategy by placing a surgical mask loosely over the tested devices. The mask is demonstrated to alleviate exposure by deflecting the exhalations from being launched directly above a supine patient. The surgical mask is found to essentially eliminate the concentrated aerosol regions above the patient over the entire oxygenation rates used in treatment in both devices.
We present high-fidelity numerical simulations of expiratory biosol transport during normal breathing under indoor, stagnant air conditions with and without a facile mask. We investigate mask efficacy to suppress the spread of saliva particles that is underpinnings existing social distancing recommendations. The present simulations incorporate the effect of human anatomy and consider a spectrum of saliva particulate sizes that range from 0.1 to 10 μm while also accounting for their evaporation. ...
4 CitationsSource
#1Chong Shen NgH-Index: 7
#2Kai Leong ChongH-Index: 11
Last. Detlef LohseH-Index: 110
view all 6 authors...
The ambient conditions surrounding liquid droplets determine their growth or shrinkage. However, the precise fate of a liquid droplet expelled from a respiratory puff as dictated by its surroundings and the puff itself has not yet been fully quantified. From the view of airborne disease transmission, such as SARS-CoV-2, knowledge of such dependencies are critical. Here we employ direct numerical simulations (DNS) of a turbulent respiratory vapour puff and account for the mass and temperature exc...
8 CitationsSource
#1Martin Z. Bazant (MIT: Massachusetts Institute of Technology)H-Index: 84
#2John W. M. Bush (MIT: Massachusetts Institute of Technology)H-Index: 45
The current revival of the American economy is being predicated on social distancing, specifically the Six-Foot Rule, a guideline that offers little protection from pathogen-bearing aerosol droplets sufficiently small to be continuously mixed through an indoor space. The importance of airborne transmission of COVID-19 is now widely recognized. While tools for risk assessment have recently been developed, no safety guideline has been proposed to protect against it. We here build on models of airb...
41 CitationsSource
#1Yusuke Matsui (Gunma University)H-Index: 2
#2Tomonori Takazawa (Gunma University)H-Index: 18
Last. Shigeru Saito (Gunma University)H-Index: 46
view all 4 authors...
2 CitationsSource
#1Liangyu Wu (YZU: Yangzhou University)H-Index: 1
#2Xiangdong Liu (YZU: Yangzhou University)H-Index: 12
Last. Yongping Chen (Suzhou University of Science and Technology)H-Index: 34
view all 4 authors...
To provide a comprehensive understanding of virus transmission inside small indoor spaces, numerical simulation of sneezing droplets spreading in a cafeteria is conducted through computational fluid dynamics. The numerical results show that dining face to face is extremely vulnerable to direct infection by others' respiratory droplets. Different heights of droplet sources are compared, which indicates that sneezing from a standing person results in a longer survival time of droplets in the air. ...
12 CitationsSource
#1Michael Klompas (Brigham and Women's Hospital)H-Index: 64
#2Meghan A. Baker (Brigham and Women's Hospital)H-Index: 17
Last. Charles A. Morris (Brigham and Women's Hospital)H-Index: 15
view all 22 authors...
BACKGROUND: Little is known about clusters of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in acute care hospitals. OBJECTIVE: To describe the detection, mitigation, and analysis of a large cluster of SARS-CoV-2 infections in an acute care hospital with mature infection control policies. DESIGN: Descriptive study. SETTING: Brigham and Women's Hospital, Boston, Massachusetts. PARTICIPANTS: Patients and staff with cluster-related SARS-CoV-2 infections. INTERVENTION: Close...
31 CitationsSource
#1Kai Leong Chong (UT: University of Twente)H-Index: 11
#2Chong Shen Ng (UT: University of Twente)H-Index: 7
Last. Detlef Lohse (UT: University of Twente)H-Index: 110
view all 6 authors...
To mitigate the COVID-19 pandemic, it is key to slow down the spreading of the life-threatening coronavirus (SARS-CoV-2). This spreading mainly occurs through virus-laden droplets expelled at speaking, coughing, sneezing, or even breathing. To reduce infections through such respiratory droplets, authorities all over the world have introduced the so-called "2-meter distance rule" or "6-foot rule". However, there is increasing empirical evidence, e.g. through the analysis of super-spreading events...
46 CitationsSource
#1Rebecca H Haraf (Case Western Reserve University)H-Index: 1
#2Mark A. FaghyH-Index: 6
Last. Richard JosephsonH-Index: 29
view all 4 authors...
Purpose Masking has been employed as a strategy for reducing transmission of a variety of communicable diseases. With the outbreak of SARS-CoV-2, many countries have implemented mandatory public masking. However, the perceived impact of mask use on pulmonary function has been a deterrent to public compliance with recommendations. COVID-19 has shed light on the impact that comorbid cardiac and pulmonary conditions may have on disease severity. This knowledge has led to increased primary and secon...
4 CitationsSource
#1Jie LiH-Index: 13
#2James B Fink (Rush University Medical Center)H-Index: 35
Last. Stephan EhrmannH-Index: 24
view all 9 authors...
High-flow nasal cannula (HFNC) has been shown to improve oxygenation and reduce the need for intubation for hypoxemic patients [1]. A retrospective study reported the effectiveness of HFNC to improve oxygenation of COVID-19 patients [2]. The transmission route of the SARS-CoV-2 virus remains controversial [3, and concerns persist of potentially increased virus transmission when utilising HFNC among COVID-19 patients [3–5]. Computational fluid dynamic simulations reported that wearing a surgical/...
11 CitationsSource
#1Brian Chang (Clark University)H-Index: 5
#2Ram Sudhir Sharma (Clark University)H-Index: 1
Last. Arshad Kudrolli (Clark University)H-Index: 38
view all 4 authors...
The authors show a hundred-fold reduction in liquid dispersed when a standard nose and mouth mask is worn, and a complete cancellation by N95 masks.
2 CitationsSource
Cited By0