ABSTRACT
Background: A proportion of patients with COVID-19 become critically ill, but few studies describe the functional outcomes and rehabilitation process of these patients. Objective(s): To describe the complications encountered and functional outcomes of critically ill COVID-19 patients requiring intubation and subsequent intensive care unit (ICU) management and rehabilitation. Method(s): Retrospective case note review was conducted on all patients requiring intubation and ICU admission and subsequently discharged from our hospital from February 15, 2020 to May 1, 2020. Demographics, preexisting medical conditions, complications encountered in ICU, ICU and General Ward Length of Stay, number of therapy sessions delivered, nutritional data, and functional outcomes on discharge were collected from electronic medical records and entered in a deidentified database. Result(s): Most patients developed significant breathlessness affecting post-ICU rehabilitation, a few patients developed ICU associated delirium while no patient developed ICU-associated weakness. All patients survived and could walk 20 m within 12 days post-extubation. Conclusion(s): Early ICU and sustained post-ICU rehabilitation of critically ill, intubated COVID-19 patients is feasible. Further studies could look into the outcomes of this group of patients, in particular the effect of nutrition and pulmonary training on functional outcomes. We strongly recommend an interdisciplinary rehabilitation team approach in managing critically ill COVID-19 patients. Copyright © The Author(s) 2022.
ABSTRACT
The COVID-19 pandemic imposes a severe challenge to the health care providers and patients in dental clinics as the dental procedures produce abundant airborne materials. Although dental practices use a multi-layered protective procedure to reduce the potential danger from dental aerosols, it is still beneficial to suppress the aerosol generation from the origin as much as possible. Reducing the aerosol generation (especially the droplets of smaller diameters) from the very beginning will ease the burden on all subsequent layers of protection. In this work, we first provide a relatively complete picture of the structure of the spray produced by the air turbine handpiece. We found that the spray consists of two domains: one is the canopy shaped centrifugal zone and the other is a dense ballistic spray core. The droplets from the centrifugal zone are much smaller than those of the spray core and, hence, are more prone to stay in the air. The location of the centrifugal zone also makes it more challenging to be contained by the mouth or rubber dam. To suppress the atomization of the centrifugal zone, we used the food-additive carboxymethylcellulose sodium (CMC-Na) water solutions of different concentrations. The data show that the viscoelastic property of the 0.5 wt. % CMC-Na water solution can effectively suppress the aerosol generation of the centrifugal zone. (C) 2022 Author(s).