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      Electrostatic Filters to Reduce COVID-19 Spread in Bubble CPAP: An in vitro Study of Safety and Efficacy


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          Bubble CPAP may be used in infants with suspected or confirmed COVID-19. Electrostatic filters may reduce cross infection. This study aims to determine if including a filter in the bubble CPAP circuit impacts stability of pressure delivery.


          A new electrostatic filter was placed before (pre) or after (post) the bubble CPAP generator, or with no filter (control) in an in vitro study. Pressure was recorded at the nasal interface for 18 h (6 L/min; 7 cm H<sub>2</sub>O) on 3 occasions for each configuration. Filter failure was defined as pressure >9 cm H<sub>2</sub>O for 60 continuous minutes. The filter was weighed before and after each experiment.


          Mean (SD) time to reach the fail point was 257 (116) min and 525 (566) min for filter placement pre- and post-CPAP generator, respectively. Mean pressure was higher throughout in the pre-generator position compared to control. The filter weight was heavier at end study in the pre- compared to the post-generator position.


          Placement of the filter at the pre-generator position in a bubble CPAP circuit should be avoided due to unstable mean pressure. Filters are likely to become saturated with water over time. The post-generator position may accommodate a filter, but regular pressure monitoring and early replacement are required.

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          Most cited references30

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          Is Open Access

          Virology, Epidemiology, Pathogenesis, and Control of COVID-19

          The outbreak of emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China has been brought to global attention and declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Scientific advancements since the pandemic of severe acute respiratory syndrome (SARS) in 2002~2003 and Middle East respiratory syndrome (MERS) in 2012 have accelerated our understanding of the epidemiology and pathogenesis of SARS-CoV-2 and the development of therapeutics to treat viral infection. As no specific therapeutics and vaccines are available for disease control, the epidemic of COVID-19 is posing a great threat for global public health. To provide a comprehensive summary to public health authorities and potential readers worldwide, we detail the present understanding of COVID-19 and introduce the current state of development of measures in this review.
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            Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients

            A global health emergency has been declared by the World Health Organization as the 2019-nCoV outbreak spreads across the world, with confirmed patients in Canada. Patients infected with 2019-nCoV are at risk for developing respiratory failure and requiring admission to critical care units. While providing optimal treatment for these patients, careful execution of infection control measures is necessary to prevent nosocomial transmission to other patients and to healthcare workers providing care. Although the exact mechanisms of transmission are currently unclear, human-to-human transmission can occur, and the risk of airborne spread during aerosol-generating medical procedures remains a concern in specific circumstances. This paper summarizes important considerations regarding patient screening, environmental controls, personal protective equipment, resuscitation measures (including intubation), and critical care unit operations planning as we prepare for the possibility of new imported cases or local outbreaks of 2019-nCoV. Although understanding of the 2019-nCoV virus is evolving, lessons learned from prior infectious disease challenges such as Severe Acute Respiratory Syndrome will hopefully improve our state of readiness regardless of the number of cases we eventually manage in Canada.
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              Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China

              This cohort study examines medical records of 33 neonates born to women with COVID-19 to provide information on maternal-child transmission and infant outcomes.

                Author and article information

                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                27 November 2020
                : 1-6
                [1] aNeonatology, Child and Adolescent Health Service, Hospital Avenue, Nedlands, Washington, Australia
                [2] bMedical School, The University of Western Australia, Perth, Washington, Australia
                [3] cSchool of Human Sciences, The University of Western Australia, Perth, Washington, Australia
                [4] dBiometrics, Telethon Kids Institute, University of Western Australia, Nedlands, Washington, Australia
                Author notes
                *Jonathan W. Davis, University of Western Australia, c/o Perth Children's Hospital, 15 Hospital Avenue, Nedlands, Perth, WA 6009 (Australia), jonathan.davis@ 123456uwa.edu.au
                Copyright © 2020 by S. Karger AG, Basel

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                : 2 September 2020
                : 8 October 2020
                Page count
                Figures: 2, Tables: 1, References: 30, Pages: 6
                Original Paper

                electrostatic filters,continuous positive airway pressure,noninvasive ventilation,pressure,infant,newborn


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