RT @doctimcook: Pleased to see this published. A study from #AERATOR published in @Anaes_Journal showing that even with a large intentiona….

Well done Fiona. Great talk.

RT @Anaes_Journal: 🔓Peri-operative cardiac arrest: management and outcomes of patients analysed in the 7th National Audit Project of the @R….

Fantastic. Well done Gus!.

Our study shows delivery of CPR generates high concentrations of respiratory aerosol. This should form part of a risk assessment for each individual patient interaction when providing CPR.

These submicron particles are from deep within the lung, can persist for prolonged periods of time in the environment once emitted and can be inhaled to the level of the alveoli.

In cardiac arrest, loss of muscle tone, fluid shifts, 100% O2 and chest compressions promote atelectasis. Re-expansion of distal lung units during ventilation generates large plumes of aerosol via this mechanism.

The bronchiolar mode is responsible for generation of the smallest particles. As the collapsed bronchiole re-expands, the fluid occluding this airway stretches into a thin film and eventually bursts, generating small particles that are expelled during the next exhalation

Respiratory aerosol generation in the lower respiratory tract is either from turbulent air flow within the large airways (causing fluid to be aerosolised by shear forces).Or via the bronchiolar mode during re-expansion of collapsed bronchioles/alveoli

Laryngeal particles are generated by turbulent air passing through partially adducted cords, and/or cord vibration during phonation/vocalisation. The loss of vocal cord activity and airway devices used in our study prevent aerosol generation from the oral cavity and larynx.

Respiratory aerosol is generated in 3 main regions: the oral cavity, the larynx and the lower respiratory tract. Particles generated in the oral cavity tend to be the largest and often follow a ballistic trajectory.

These findings were further explored in a porcine model (accounting for intersubject variability and allowing aerosol sampling immediately after arrest). This showed ventilation following cardiac arrest generates 270 times more aerosol than ventilation before cardiac arrest. Why?.

We recorded very high aerosol concentrations during of out-of-hospital cardiac arrest management. This was 1-2 orders of magnitude higher than ventilating a similar cohort of anaesthetised patients with an equivalent respiratory pattern.

This was a complex study due to the inherent challenges of undertaking cardiac arrest research in humans combined with using highly sensitive aerosol detection instruments in a range of unpredictable environments.

Very proud to have this paper out. Huge amount of thanks to @GWAAC, @Swasft, @vickibrown999 @JerryPNolan @jas_soar @gushamilton @doctimcook @TonyPi314 @drjulesbrown, Profs Ascione, Reid and Benger, TBRC staff @BristolUni, Bristol Aerosol Research Centre and the other co-authors.

RT @Anaes_Journal: 🔓Cardiopulmonary resuscitation generates 100-fold higher concentrations of respiratory aerosol than in awake or anaesthe….

RT @morefluids: Really excited to be standing for Association of Anaesthetists Trainee Committee elections alongside a strong group. It wou….

Thanks Jan. Great talk on a really important topic. Our studies are the result of a collaboration between aerosol scientists and clinicians. Proud to see our work recognised by @Anaes_Journal . Huge thanks to @doctimcook @TonyPi314 @drjulesbrown @BristolARCentre @gushamilton.

Top work! Proud to have been a part of it.

A great event to have been a part of (even if done so remotely).