Observational studyAnaesthesia2021
Aerosolisation during tracheal intubation and extubation in an operating theatre setting.
Observational study in Anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Comparison of Postextubation Complications Between Positive-Pressure and Suctioning Techniques: A Systematic Review.Respiratory care · 2023Pooled it
- Epidemiology and Outcome of Out-of-Hospital Cardiac Arrests during the COVID-19 Pandemic in South Korea: A Systematic Review and Meta-Analyses.Yonsei medical journal · 2022Pooled it
- Timing and type of personal protective equipment adherence lapses in pediatric trauma resuscitation: A retrospective video study.American journal of infection control · 2025Article
- Comparison of Aerosol Generation Between Bag Valve and Chest Compression-Synchronized Ventilation During Simulated Cardiopulmonary Resuscitation.Journal of clinical medicine · 2025Article
- Factors associated with correction of personal protective equipment nonadherence in a multidisciplinary emergency department setting: A retrospective video review.American journal of infection control · 2025Article
- Impact of the Coronavirus Pandemic on Patients Requiring Tracheal Intubation by Helicopter Emergency Medical Services: A Retrospective, Single-Center, Observational Study.Journal of clinical medicine · 2024Article
- Balancing Act: Evaluating the Need for Airborne Isolation Tools-Sometimes More Is Less.Respiratory care · 2024Article
- Concurrent SARS-COV-19 and acute appendicitis: Management and outcomes across United States children's hospitals.Surgery · 2023Article
- The effect of clinical face shields on aerosolized particle exposure.Journal of 3D printing in medicine · 2023Article
- Risk of Bacterial Exposure to the Anesthesiologist's Face During Intubation and Extubation.Infection and drug resistance · 2023Article
- Re-evaluating our language when reducing risk of SARS-CoV-2 transmission to healthcare workers: Time to rethink the term, "aerosol-generating procedures".Virology journal · 2022Review
- Human Factors and Airway Management in COVID-19 Patients: The Perfect Storm?Journal of clinical medicine · 2022Article
- Effects of wearing surgical masks on fraction of inspired oxygen in spontaneously breathing patients: improving safety for frontline healthcare professionals under pandemic situations.BMC anesthesiology · 2022Article
- Aerosol generation during general anesthesia is comparable to coughing: An observational clinical study.Acta anaesthesiologica Scandinavica · 2022Observational
- Computational modelling of an aerosol extraction device for use in COVID-19 surgical tracheotomy.Journal of aerosol science · 2022Article
- Article
- Evidence-based aerosol clearance times in a healthcare environment.Infection prevention in practice · 2021Article
- The Influence of COVID-19 on Out-Hospital Cardiac Arrest Survival Outcomes: An Updated Systematic Review and Meta-Analysis.Journal of clinical medicine · 2021Review
- The effect of respiratory activity, non-invasive respiratory support and facemasks on aerosol generation and its relevance to COVID-19.Anaesthesia · 2021Article
- Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aerosol-generating procedures such as tracheal intubation and extubation pose a potential risk to healthcare workers because of the possibility of airborne transmission of infection. Detailed characterisation of aerosol quantities, particle size and generating activities has been undertaken in a number of simulations but not in actual clinical practice. The aim of this study was to determine whether the processes of facemask ventilation, tracheal intubation and extubation generate aerosols in clinical practice, and to characterise any aerosols produced. In this observational study, patients scheduled to undergo elective endonasal pituitary surgery without symptoms of COVID-19 were recruited. Airway management including tracheal intubation and extubation was performed in a standard positive pressure operating room with aerosols detected using laser-based particle image velocimetry to detect larger particles, and spectrometry with continuous air sampling to detect smaller particles. A total of 482,960 data points were assessed for complete procedures in three patients. Facemask ventilation, tracheal tube insertion and cuff inflation generated small particles 30-300 times above background noise that remained suspended in airflows and spread from the patient's facial region throughout the confines of the operating theatre. Safe clinical practice of these procedures should reflect these particle profiles. This adds to data that inform decisions regarding the appropriate precautions to take in a real-world setting.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.