Late Breaking Abstract - Exhaled air dispersion during application of CPAP via nasal pillows and oronasal mask versus high flow nasal cannula therapy

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Aims: An infection control study to examine exhaled air dispersion during application of CPAP via nasal pillows and an oronasal mask versus high flow nasal cannula(HFNC) on a human patient simulator(HPS) in a hospital isolation room with 16 air changes/hr. Methods: The HPS was placed at 45° and programmed to mimic different severity of lung injury. CPAP was delivered from 5 to 20cmH20 via gel nasal pillows (Respironics) and oronasal mask (Quattro Air, ResMed) respectively. HFNC with air humidified to 37°C was delivered at 10 to 60L/min respectively to the HPS. Airflow was marked with intrapulmonary smoke for visualization. A leakage jet plume in the sagittal plane was revealed by a laser light-sheet and images captured by high definition video. Normalized exhaled air concentration in the plume was estimated from the light scattered by the smoke particles. Significant exposure was defined as where there was ≥20% of normalized smoke concentration. Results: When the HPS was programmed in normal lung condition, the exhaled air distances along the sagittal plane increased from 186 to 264mm respectively when CPAP was applied via nasal pillows from 5 to 20cmH20 while that from the oronasal mask was negligible. When HFNC was delivered from 10 to 60L/min, the exhaled air distances along the sagittal plane above the nostrils were 65 to 172mm respectively. Conclusion: Exhaled air dispersion from the patient’s nostrils was limited to 172mm along the sagittal plane when HFNC was delivered at 60L/min. Exhaled air dispersed to 264mm during CPAP via nasal pillows but that from Quattro oronasal mask was negligible. Projected funded by HMRF#15140282, Food & Health Bureau, HK

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