Preclinical validation of occupational and environmental safety of an isolation system for non-invasive ventilation in COVID-19 and other aerosol-transmitted infections.

Quadros, Claudio Almeida; Leal, Maria Carolina Bezerra Di Medeiros; Baptista-Sobrinho, Carlos de Almeida; Nonaka, Carolina Kymie Vasques; Souza, Bruno Solano de Freitas; Milan-Mattos, Juliana Cristina; Catai, Aparecida Maria; Pires Di Lorenzo, Valéria Amorim; Ferreira, Antonio Gilberto

BACKGROUND Current SARS-CoV-2 pandemic has provoked the collapse of some health systems due to insufficient intensive care unit capacity. The use of continuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) therapies have been limited in consideration of the risk of occupational infection in healthcare professionals. AIMS In preclinical experimental simulations, evaluate occupational and environmental safety of the newly developed isolation system for aerosol transmitted infections (ISATI). METHOD Simulations were conducted to test ISATI's capability to isolate aerosolized molecular (caffeine), and biological (SARS-CoV-2 synthetic RNA) markers. Caffeine deposition was analyzed on nitrocellulose sensor discs by proton nuclear magnetic resonance spectroscopy. Synthetic SARS-CoV-2 detection was performed by reverse transcription polymerase chain reaction. RESULTS ISATI demonstrated efficacy in isolating molecular and biological markers within the enclosed environment in simulated conditions of CPAP, HFNO and mechanical ventilation therapy. Neither the molecular marker nor substantial amounts of synthetic SARS-CoV-2 RNA were detected in the surrounding environment, outside ISATI, indicating appropriate occupational safety for healthcare professionals. CONCLUSION Aerosolized markers were successfully contained within ISATI in all experimental simulations, offering occupational and environmental protection against the dissemination of aerosolized microparticles under CPAP or HFNO therapy conditions, which are indicated for patients with acute respiratory infections.