Clin Endosc.  2022 Mar;55(2):226-233. 10.5946/ce.2021.178-IDEN.

Preclinical Efficacy and Clinical Feasibility of a Novel Aerosol-Exposure Protection Mask for Esophagogastroduodenoscopy

• Makiguchi ME
• Abe S
• Okagawa Y
• Nonaka S
• Suzuki H
• Yoshinaga S
• Oda I
• Ryuta O
• Saito Y

• KMID: 2527566
• DOI: http://doi.org/10.5946/ce.2021.178-IDEN

Abstract

Background/Aims
This study aimed to assess the efficacy of a novel aerosol-exposure protection (AP) mask in preventing coronavirus disease in healthcare professionals during upper gastrointestinal endoscopy and to evaluate its clinical feasibility.
Methods
In Study 1, three healthy volunteers volitionally coughed with and without the AP mask in a cleanroom. Microparticles were visualized and counted with a specific measurement system and compared with and without the AP mask. In Study 2, 30 patients underwent endoscopic resection with the AP mask covering the face, and the SpO2 was measured throughout the procedure.
Results
In Study 1, the median number of microparticles in volunteers 1, 2, and 3 with and without the AP mask was 8.5 and 110.0, 7.0 and 51.5, and 8.0 and 95.0, respectively (p<0.01). Using the AP mask, microparticles were reduced by approximately 92%. The median distances of microparticle scattering without the AP mask were 60, 0, and 68 in volunteers 1, 2, and 3, respectively. In Study 2, the mean SpO2 was 96.3%, and desaturation occurred in three patients.
Conclusion
The AP mask could provide protection from aerosol exposure and can be safely used for endoscopy in clinical practice.

Keyword

COVID-19; Gastrointestinal endoscopy; Personal protective equipment

Figure

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  Fig. 1. How to make aerosol-exposure protection (AP) mask. (A) Materials of the AP mask: an A4-sized plastic folder, string, and two pieces of gauze pad. (B) An A4-sized plastic folder was cut into a 12.5×12.5 cm square, and a 3.5 cm square was cut from its corner. (C) To insert the string, a small hole was made in the plastic folder and two pieces of gauze pad. (D) The gauze was placed on the edges of the plastic file holder with a string. (E) A healthy volunteer wearing the mask.

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  Fig. 2. Schematic illustration of experimental design in a cleanroom. (A) A healthy volunteer without the aerosol-exposure protection (AP) mask. (B) A healthy volunteer with the AP mask. (C) Schematic illustration of the experimental design in a cleanroom.

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  Fig. 3. Visualization of aerosol particles by light-emitting diode during simulated endoscopy.

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  Fig. 4. Droplets were identified inside the aerosol-exposure protection mask during endoscopic procedures.

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