J. Shin, Grogan, Lee, Liew, Umar, D. Shin, Hoftman: A novel negative pressure isolation device reduces aerosol exposure: A randomized controlled trial

Published on March 6, 2023

During the COVID-19 pandemic, intubation barriers arose as a protection measure against infection for healthcare workers. A UCLA team, including John Shin, MD, Tristan Grogan, MS, Jason Lee, MD, Elaine Liew, MD, Soban Umar, MD, PhD, Dong Ho Shin, and Nir Hoftman, MD, developed the Suction-Assisted Local Aerosol Containment Chamber (SLACC) and assessed its efficacy in this study. The researchers made the design of the SLACC device open access so that anyone can make and use it should the need arise.

Abstract

"Background: The COVID-19 pandemic has led to a proliferation of intubation barriers designed to protect healthcare workers from infection. We developed the Suction-Assisted Local Aerosol Containment Chamber (SLACC) and tested it in the operating room. The primary objectives were to determine the ease and safety of airway management with SLACC, and to measure its efficacy of aerosol containment to determine if it significantly reduces exposure to health care workers.

Methods: In this randomized clinical trial, adult patients scheduled to undergo elective surgery with general endotracheal anesthesia were screened and informed consent obtained from those willing to participate. Patients were randomized to airway management either with or without the SLACC device. Patients inhaled nebulized saline before and during anesthesia induction to simulate the size and concentration of particles seen with severe symptomatic SARS-CoV-2 infection.

Results: 79 patients were enrolled and randomized. Particle number concentration (PNC) at the patients' and healthcare workers’ locations were measured and compared between the SLACC vs. control groups during airway management. Ease and success of tracheal intubation were recorded for each patient. All intubations were successful and time to intubation was similar between the two groups. Healthcare workers were exposed to significantly lower particle number concentrations (#/cm3) during airway management when SLACC was utilized vs. control. The particle count outside SLACC was reduced by 97% compared to that inside the device.

Conclusions: The SLACC device does not interfere with airway management and significantly reduces healthcare worker exposure to aerosolized particles during airway management."

Read more in Trends in Anaesthesia and Critical Care.