Observational studyGastrointestinal endoscopy2022
Aerosol and droplet generation in upper and lower GI endoscopy: whole procedure and event-based analysis.
Observational study in Gastrointestinal endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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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
15 citing papers in PubMed, 23 citations in OpenAlex.
- Covering the biopsy hole check valve with "enzymolysis gauze" reduces bacterial contamination in the endoscopy room.World journal of gastroenterology · 2025Article
- Best practice of gastrointestinal endoscopy during Mpox upsurge: an Indonesian Society for Digestive Endoscopy recommendation.Clinical endoscopy · 2025Review
- Quantifying aerosol and microbial exposure of healthcare workers in endoscopy suites: a time-based study.Frontiers in public health · 2025Article
- Aerosol protection using modified N95 respirator during upper gastrointestinal endoscopy: a randomized controlled trial.Clinical endoscopy · 2024Article
- Cytosponge procedures produce fewer respiratory aerosols and droplets than esophagogastroduodenoscopies.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2024Article
- Bronchoscopy masks mitigate aerosols during upper gastrointestinal endoscopies.Endoscopy international open · 2023Article
- Necessity of pharyngeal anesthesia during transoral gastrointestinal endoscopy: a randomized clinical trial.Clinical endoscopy · 2023Article
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- Article
- Does an Extraoral Suction Device Reduce Aerosol Generation and Prevent Droplet Exposure to the Examiner during Esophagogastroduodenoscopy?Journal of clinical medicine · 2023Article
- Gastrointestinal Endoscopy in Patients with Coronavirus Disease 2019: Indications, Findings, and Safety.Gastroenterology clinics of North America · 2023Review
- Article
- Management of aerosol generation during upper gastrointestinal endoscopy.Clinical endoscopy · 2022Review
- Unsedated Transnasal Endoscopy: A Safe, Well-Tolerated and Accurate Alternative to Standard Diagnostic Peroral Endoscopy.Digestive diseases and sciences · 2022Review
- Transnasal endoscopy: moving from endoscopy to the clinical outpatient-blue sky thinking in oesophageal testing.Frontline gastroenterology · 2022Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsAerosol-generating procedures have become an important healthcare issue during the coronavirus disease 2019 (COVID-19) pandemic because the severe acute respiratory syndrome coronavirus 2 virus can be transmitted through aerosols. We aimed to characterize aerosol and droplet generation in GI endoscopy, where there is little evidence.
methodsThis prospective observational study included 36 patients undergoing routine peroral gastroscopy (POG), 11 undergoing transnasal endoscopy (TNE), and 48 undergoing lower GI (LGI) endoscopy. Particle counters took measurements near the appropriate orifice (2 models were used with diameter ranges of .3-25 μm and 20-3000 μm). Quantitative analysis was performed by recording specific events and subtracting background particles.
resultsPOG produced 1.96 times the level of background particles (P < .001) and TNE produced 2.00 times (P < .001), but a direct comparison showed POG produced 2.00 times more particles than TNE. LGI procedures produced significant particle counts (P < .001) with 2.4 times greater production per procedure than POG but only .63 times production per minute. Events that were significant relative to the room background particle count were POG, with throat spray (150.0 times, P < .001), esophageal extubation (37.5 times, P < .001), and coughing or gagging (25.8 times, P < .01); TNE, with nasal spray (40.1 times, P < .001), nasal extubation (32.0 times, P < .01), and coughing or gagging (20.0, P < .01); and LGI procedures, with rectal intubation (9.9 times, P < .05), rectal extubation (27.2 times, P < .01), application of abdominal pressure (9.6 times, P < .05), and rectal insufflation or retroflexion (7.7 times, P < .01). These all produced particle counts larger than or comparable with volitional cough.
conclusionsGI endoscopy performed through the mouth, nose, or rectum generates significant quantities of aerosols and droplets. Because the infectivity of procedures is not established, we therefore suggest adequate personal protective equipment is used for all GI endoscopy where there is a high population prevalence of COVID-19. Avoiding throat and nasal spray would significantly reduce particles generated from upper GI procedures.
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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.