Aerosol emission and exposure in non-invasive ventilation
Abstract From the beginning of the COVID-19 pandemic, there has been concern among clinicians whether the use of high-flow nasal cannula (HFNC) and continuous positive airway pressure (CPAP) contributes to aerosol generation and consequently spreading of pathogens. Most guidelines still classify the...
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Nature Portfolio
2025-04-01
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| Online Access: | https://doi.org/10.1038/s41598-025-98751-0 |
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| author | Petra Nikuri Anthony Maalouf Ahmed Geneid Eero Pesonen Enni Sanmark Ville A. Vartiainen |
| author_facet | Petra Nikuri Anthony Maalouf Ahmed Geneid Eero Pesonen Enni Sanmark Ville A. Vartiainen |
| author_sort | Petra Nikuri |
| collection | DOAJ |
| description | Abstract From the beginning of the COVID-19 pandemic, there has been concern among clinicians whether the use of high-flow nasal cannula (HFNC) and continuous positive airway pressure (CPAP) contributes to aerosol generation and consequently spreading of pathogens. Most guidelines still classify these treatments as high-risk aerosol-generating procedures. The aim of this study was to evaluate differences in aerosol emissions and exposure with CPAP and HFNC compared to no breathing aid (NBA). Aerosol emissions of 16 healthy volunteers using CPAP, HFNC and NBA were measured with a portable aerosol spectrometer. During each measurement, the volunteers were instructed consecutively to breathe normally, breathe deeply, cough and read aloud a predefined text. The Wilcoxon signed-rank test was used in statistical analysis. Non-invasive ventilation (CPAP, HFNC) does not produce significantly more aerosol than the same respiratory activities without a breathing aid (median CPAP-NBA − 4.54 1/L, p = 0.816, and HFNC-NBA 2.27 1/L, p = 0.244), deep breathing (median CPAP-NBA − 2.27 1/L, p = 0.378 and HFNC-NBA 4.55 1/L, p = 0.623), speaking (median CPAP-NBA 0 1/L, p = 0.0523 and HFNC-NBA 9.09 1/L, p = 0.0140), or coughing (median CPAP-NBA − 17.31 1/L, p = 0.587 and HFNC-NBA 1.92 1/L, p = 0.365). The results indicate that both CPAP and HFNC have no clinically meaningful impact on aerosol emission. Therefore, the use of CPAP or HFNC does not expose healthcare personnel to greater concentrations of aerosols when compared to normal breathing in healthy participants. |
| format | Article |
| id | doaj-art-bc5195fafc6746dbb4734bacce66a32d |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-bc5195fafc6746dbb4734bacce66a32d2025-08-20T02:19:58ZengNature PortfolioScientific Reports2045-23222025-04-011511610.1038/s41598-025-98751-0Aerosol emission and exposure in non-invasive ventilationPetra Nikuri0Anthony Maalouf1Ahmed Geneid2Eero Pesonen3Enni Sanmark4Ville A. Vartiainen5Heart and Lung Center, Faculty of Medicine, Helsinki University Hospital, University of HelsinkiDepartment of Otorhinolaryngology ja Phoniatrics - Head and Neck Surgery, University of Helsinki and Helsinki University HospitalDepartment of Otorhinolaryngology ja Phoniatrics - Head and Neck Surgery, University of Helsinki and Helsinki University HospitalDepartment of Anesthesiology and Intensive Care Medicine, University of Helsinki and Helsinki University HospitalHeart and Lung Center, Faculty of Medicine, Helsinki University Hospital, University of HelsinkiHeart and Lung Center, Faculty of Medicine, Helsinki University Hospital, University of HelsinkiAbstract From the beginning of the COVID-19 pandemic, there has been concern among clinicians whether the use of high-flow nasal cannula (HFNC) and continuous positive airway pressure (CPAP) contributes to aerosol generation and consequently spreading of pathogens. Most guidelines still classify these treatments as high-risk aerosol-generating procedures. The aim of this study was to evaluate differences in aerosol emissions and exposure with CPAP and HFNC compared to no breathing aid (NBA). Aerosol emissions of 16 healthy volunteers using CPAP, HFNC and NBA were measured with a portable aerosol spectrometer. During each measurement, the volunteers were instructed consecutively to breathe normally, breathe deeply, cough and read aloud a predefined text. The Wilcoxon signed-rank test was used in statistical analysis. Non-invasive ventilation (CPAP, HFNC) does not produce significantly more aerosol than the same respiratory activities without a breathing aid (median CPAP-NBA − 4.54 1/L, p = 0.816, and HFNC-NBA 2.27 1/L, p = 0.244), deep breathing (median CPAP-NBA − 2.27 1/L, p = 0.378 and HFNC-NBA 4.55 1/L, p = 0.623), speaking (median CPAP-NBA 0 1/L, p = 0.0523 and HFNC-NBA 9.09 1/L, p = 0.0140), or coughing (median CPAP-NBA − 17.31 1/L, p = 0.587 and HFNC-NBA 1.92 1/L, p = 0.365). The results indicate that both CPAP and HFNC have no clinically meaningful impact on aerosol emission. Therefore, the use of CPAP or HFNC does not expose healthcare personnel to greater concentrations of aerosols when compared to normal breathing in healthy participants.https://doi.org/10.1038/s41598-025-98751-0Aerosol emissionHigh-Flow nasal cannula (HFNC)Continuous positive airway pressure (CPAP)Respiratory aerosols |
| spellingShingle | Petra Nikuri Anthony Maalouf Ahmed Geneid Eero Pesonen Enni Sanmark Ville A. Vartiainen Aerosol emission and exposure in non-invasive ventilation Scientific Reports Aerosol emission High-Flow nasal cannula (HFNC) Continuous positive airway pressure (CPAP) Respiratory aerosols |
| title | Aerosol emission and exposure in non-invasive ventilation |
| title_full | Aerosol emission and exposure in non-invasive ventilation |
| title_fullStr | Aerosol emission and exposure in non-invasive ventilation |
| title_full_unstemmed | Aerosol emission and exposure in non-invasive ventilation |
| title_short | Aerosol emission and exposure in non-invasive ventilation |
| title_sort | aerosol emission and exposure in non invasive ventilation |
| topic | Aerosol emission High-Flow nasal cannula (HFNC) Continuous positive airway pressure (CPAP) Respiratory aerosols |
| url | https://doi.org/10.1038/s41598-025-98751-0 |
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