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Aerosol precautions and airway complications: a national prospective multicentre cohort study.
Potter, T; Cronin, J N; Kua, J; Nurmi, E; Wong, D J N; Ahmad, I; Cook, T M; El-Boghdadly, K.
  • Potter T; Department of Anaesthesia and Peri-operative Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
  • Cronin JN; Department of Anaesthesia and Peri-operative Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
  • Kua J; Surgical Outcomes Research Centre, University College London, UK.
  • Nurmi E; Department of Anaesthesia and Peri-operative Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
  • Wong DJN; Department of Anaesthesia and Peri-operative Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
  • Ahmad I; Department of Anaesthesia and Peri-operative Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
  • Cook TM; King's College London, UK.
  • El-Boghdadly K; Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.
Anaesthesia ; 78(1): 23-35, 2023 01.
Article in English | MEDLINE | ID: covidwho-2019116
ABSTRACT
The perceived risk of transmission of aerosolised viral particles from patients to airway practitioners during the COVID-19 pandemic led to the widespread use of aerosol precautions, including personal protective equipment and modifications to anaesthetic technique. The risk of these aerosol precautions on peri-operative airway complications has not been assessed outside of simulation studies. This prospective, national, multicentre cohort study aimed to quantify this risk. Adult patients undergoing general anaesthesia for elective or emergency procedures over a 96-hour period were included. Data collected included use of aerosol precautions by the airway practitioner, airway complications and potential confounding variables. Mixed-effects logistic regression was used to assess the risk of individual aerosol precautions on overall and specific airway complications. Data from 5905 patients from 70 hospital sites were included. The rate of airway complications was 10.0% (95%CI 9.2-10.8%). Use of filtering facepiece class 2 or class 3 respirators was associated with an increased risk of airway complications (odds ratio 1.38, 95%CI 1.04-1.83), predominantly due to an association with difficult facemask ventilation (odds ratio 1.68, 95%CI 1.09-2.61) and desaturation on pulse oximetry (odds ratio 2.39, 95%CI 1.26-4.54). Use of goggles, powered air-purifying respirators, long-sleeved gowns, double gloves and videolaryngoscopy were not associated with any alteration in the risk of airway complications. Overall, the use of filtering facepiece class 2 or class 3 respirators was associated with an increased risk of airway complications, but most aerosol precautions used during the COVID-19 pandemic were not.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Language: English Journal: Anaesthesia Year: 2023 Document Type: Article Affiliation country: Anae.15851

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Language: English Journal: Anaesthesia Year: 2023 Document Type: Article Affiliation country: Anae.15851