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Aerosol protection using modified N95 respirator during upper gastrointestinal endoscopy: a randomized controlled trial
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Chawisa Nampoolsuksan, Thawatchai Akaraviputh, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn, Varut Lohsiriwat, Vitoon Chinswangwatanakul
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Clin Endosc 2024;57(3):335-341. Published online June 21, 2023
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DOI: https://doi.org/10.5946/ce.2023.018
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 Graphical Abstract
 Abstract
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 - Background
/Aims: The coronavirus disease 2019 pandemic has affected the worldwide practice of upper gastrointestinal endoscopy. Here we designed a modified N95 respirator with a channel for endoscope insertion and evaluated its efficacy in upper gastrointestinal endoscopy.
Methods
Thirty patients scheduled for upper gastrointestinal endoscopy were randomized into the modified N95 (n=15) or control (n=15) group. The mask was placed on the patient after anesthesia administration and particles were counted every minute before (baseline) and during the procedure by a TSI AeroTrak particle counter (9306-04; TSI Inc.) and categorized by size (0.3, 0.5, 1, 3, 5, and 10 µm). Differences in particle counts between time points were recorded.
Results
During the procedure, the modified N95 group displayed significantly smaller overall particle sizes than the control group (median [interquartile range], 231 [54–385] vs. 579 [213–1,379]×103/m3; p=0.056). However, the intervention group had a significant decrease in 0.3-µm particles (68 [–25–185] vs. 242 [72–588]×103/m3; p=0.045). No adverse events occurred in either group. The device did not cause any inconvenience to the endoscopists or patients.
Conclusions
This modified N95 respirator reduced the number of particles, especially 0.3-µm particles, generated during upper gastrointestinal endoscopy.
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Management of aerosol generation during upper gastrointestinal endoscopy
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Chawisa Nampoolsuksan, Vitoon Chinswangwatanakul, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn, Thawatchai Akaraviputh
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Clin Endosc 2022;55(5):588-593. Published online August 24, 2022
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DOI: https://doi.org/10.5946/ce.2022.062
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Abstract
PDFPubReaderePub
- In the highly contagious coronavirus disease 2019 pandemic, aerosol-generating procedures (AGPs) are associated with high-risk of transmission. Upper gastrointestinal endoscopy is a procedure with the potential to cause dissemination of bodily fluids. At present, there is no consensus that endoscopy is defined as an AGP. This review discusses the current evidence on this topic with additional management. Prevailing publications on coronavirus related to upper gastrointestinal endoscopy and aerosolization from the PubMed and Scopus databases were searched and reviewed. Comparative quantitative analyses showed a significant elevation of particle numbers, implying that aerosols were generated by upper gastrointestinal endoscopy. The associated source events have also been reported. To reduce the dispersion, certain protective measures have been developed. Endoscopic unit protocols are recommended for the concerned personnel. Therefore, upper gastrointestinal endoscopy should be classified as an AGP. Proper practices should be adopted by healthcare workers and patients.
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Citations
Citations to this article as recorded by  - Aerosol protection using modified N95 respirator during upper gastrointestinal endoscopy: a randomized controlled trial
Chawisa Nampoolsuksan, Thawatchai Akaraviputh, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn,
Clinical Endoscopy.2024; 57(3): 335. CrossRef - Gastrointestinal Endoscopy in Patients with Coronavirus Disease 2019
Shahnaz Sultan
Gastroenterology Clinics of North America.2023; 52(1): 157. CrossRef - Does an Extraoral Suction Device Reduce Aerosol Generation and Prevent Droplet Exposure to the Examiner during Esophagogastroduodenoscopy?
Shintaro Fujihara, Hideki Kobara, Noriko Nishiyama, Naoya Tada, Yasuhiro Goda, Kazuhiro Kozuka, Takanori Matsui, Taiga Chiyo, Nobuya Kobayashi, Tatsuo Yachida, Tsutomu Masaki
Journal of Clinical Medicine.2023; 12(7): 2574. CrossRef
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