Ventilation-Based Strategy to Manage Intraoperative Aerosol Viral Transmission in the Era of SARS-CoV-2.

ABSTRACT

In operating theaters, ventilation systems are designed to protect the patient from airborne contamination for minimizing risks of surgical site infections (SSIs). Ventilation systems often produce an airflow pattern that continuously pushes air out of the area surrounding the operating table, and hence reduces the resident time of airborne pathogen-carrying particles at the patient's location. As a result, patient-released airborne particles due to the use of powered tools, such as surgical smoke and insufflated CO2, typically circulate within the room. This circulation exposes the surgical team to airborne infection-especially when operating on a patient with infectious diseases, including COVID-19. This study examined the flow pattern of functional ventilation configurations in view of developing ventilation-based strategies to protect both the patient and the surgical team from aerosolized infections. A favorable design that minimized particle circulation was deduced using experimentally validated numerical models. The parameters adapted to quantify circulation of airborne particles were particles' half-life and elevation. The results show that the footprint of the outlet ducts and resulting flow pattern are important parameters for minimizing particle circulation. Overall, this study presents a modular framework for optimizing the ventilation systems that permits a switch in operation configuration to suit different operating procedures.