https://orcid.org/0000-0002-2310-0536
Abstract
The potential for characterizing aerosol generating procedures (AGPs) using background oriented schlieren (BOS) flow visualization was investigated in two clinical situations. A human-scale BOS system was used on a manikin simulating jet ventilation and extubation. A novel approach to representation of the BOS images using line integral convolution allows direct evaluation of both magnitude and direction of the refractive index gradient field. Plumes issuing from the manikin's mouth were clearly visualized and characterized in both experiments, and it is recommended that BOS be adapted into a clinical tool for risk evaluation in clinical environments.
Issue Section:
Technical Briefs
References
1.
Klompas
,
M.
,
Baker
,
M.
, and
Rhee
,
C.
, 2020
, “
What is an Aerosol-Generating Procedure?
,” JAMA Surg.
, 156, pp. 113
–114
.10.1001/jamasurg.2020.66432.
Liu
,
J.
,
Liao
,
X.
,
Qian
,
S.
,
Yuan
,
J.
,
Wang
,
F.
,
Liu
,
Y.
,
Wang
,
Z.
,
Wang
,
F.
,
Liu
,
L.
, and
Zhang
,
Z.
, 2020
, “
Community Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, Shenzhen, China, 2020
,” Emerging Infect. Dis.
,
26
(6
), pp. 1320
–1323
.10.3201/eid2606.2002393.
Gralton
,
J.
,
Tovey
,
E. R.
,
McLaws
,
M.-L.
, and
Rawlinson
,
W. D.
, 2013
, “
Respiratory Virus RNA is Detectable in Airborne and Droplet Particles
,” J. Med. Virol.
,
85
(12
), pp. 2151
–2159
.10.1002/jmv.236984.
Asadi
,
S.
,
Wexler
,
A. S.
,
Cappa
,
C. D.
,
Barreda
,
S.
,
Bouvier
,
N. M.
, and
Ristenpart
,
W. D.
, 2019
, “
Aerosol Emission and Superemission During Human Speech Increase With Voice Loudness
,” Sci. Rep.
,
9
(1
).5.
Jackson
,
T.
,
Deibert
,
D.
,
Wyatt
,
G.
,
Durand-Moreau
,
Q.
,
Adisesh
,
A.
,
Khunti
,
K.
,
Khunti
,
S.
, et al., 2020
, “
Classification of Aerosol-Generating Procedures: A Rapid Systematic Review
,” BMJ Open Respir. Res.
,
7
(1
), p. e000730.10.1136/bmjresp-2020-0007306.
Bourouiba
,
L.
, 2020
, “
Turbulent Gas Clouds and Respiratory Pathogen Emissions
,” JAMA
, 323, pp. 1837
–1838
.10.1001/jama.2020.47567.
Bahl
,
P.
,
Doolan
,
C.
,
de Silva
,
C.
,
Chughtai
,
A. A.
,
Bourouiba
,
L.
, and
MacIntyre
,
C. R.
, 2022
, “
Airborne or Droplet Precautions for Health Workers Treating Coronavirus Disease 2019?
,” J. Infect. Dis.
,
225
(9
), pp. 1561
–1568
.10.1093/infdis/jiaa1898.
Raffel
,
M.
,
Willert
,
C. E.
,
Scarano
,
F.
,
Kähler
,
C. J.
,
Wereley
,
S. T.
, and
Kompenhans
,
J.
, 2018
, Particle Image Velocimetry: A Practical Guide
,
Springer
, Berlin.9.
Poggie
,
J.
,
Erbland
,
P. J.
,
Smits
,
A. J.
, and
Miles
,
R. B.
, 2004
, “
Quantitative Visualization of Compressible Turbulent Shear Flows Using Condensate-Enhanced Rayleigh Scattering
,” Exp. Fluids
,
37
(3
), pp. 438
–454
.10.1007/s00348-004-0828-910.
Settles
,
G. S.
, 2001
, Schlieren and Shadowgraph Techniques
, 1st ed.,
Springer
,
Berlin
.11.
Tang
,
J. W.
,
Liebner
,
T. J.
,
Craven
,
B. A.
, and
Settles
,
G. S.
, 2009
, “
A Schlieren Optical Study of the Human Cough With and Without Wearing Masks for Aerosol Infection Control
,” J. R. Soc. Interface
,
6
(suppl_6
), pp. S727–S736.10.1098/rsif.2009.0295.focus12.
Tang
,
J. W.
,
Nicolle
,
A. D. G.
,
Pantelic
,
J.
,
Jiang
,
M.
,
Sekhr
,
C.
,
Cheong
,
D. K. W.
, and
Tham
,
K. W.
, 2011
, “
Qualitative Real-Time Schlieren and Shadowgraph Imaging of Human Exhaled Airflows: An Aid to Aerosol Infection Control
,” PLoS ONE
,
6
(6
).10.1371/annotation/bc0b9ac0-b1d4-44ff-aa8c-cb27e199c1b113.
Staymates
,
M.
, 2020
, “
Flow Visualization of an N95 Respirator With and Without an Exhalation Valve Using Schlieren Imaging and Light Scattering
,” Phys. Fluids
,
32
(11
), p. 111703.10.1063/5.003199614.
Raffel
,
M.
, 2015
, “
Background-Oriented Schlieren (BOS) Techniques
,” Exp. Fluids
,
56
(3
), p. 60
.10.1007/s00348-015-1927-515.
Mok
,
T.
,
Harris
,
E.
,
Vargas
,
A.
,
Afshar
,
Y.
,
Han
,
C. S.
,
Karagozian
,
A.
, and
Rao
,
R.
, 2021
, “
Evaluation of Respiratory Emissions During Labor and Delivery
,” Obstet. Gynecol.
,
138
(4
), pp. 616
–621
.10.1097/AOG.000000000000453316.
Hendiger
,
J.
,
Chludzińska
,
M.
, and
Zietek
,
P.
, 2020
, “
Assessment of the Background Oriented Schlieren Application in Testing the Temperature Limit of an Axisymmetric Ventilation Jet
,” J. Build. Eng.
, 35, p. 101964
.10.1016/j.jobe.2020.10196417.
Schmidt
,
B. E.
, and
Woike
,
M. R.
, 2021
, “
Wavelet-Based Optical Flow Analysis (wOFA) for Background Oriented Schlieren (BOS) Image Processing
,” AIAA J.
, 59, epub.10.2514/1.J06021818.
Laidlaw
,
D. H.
,
Kirby
,
R. M.
,
Jackson
,
C. D.
,
Davidson
,
J. S.
,
Miller
,
T. S.
,
da Silva
,
M.
,
Warren
,
W. H.
, and
Tarr
,
M. J.
, 2005
, “
Comparing 2D Vector Field Visualization Methods: A User Study
,” IEEE Trans. Visualization Comput. Graph.
,
11
(1
), pp. 59
–70
.10.1109/TVCG.2005.419.
Cabral
,
B.
, and
Leedom
,
L. C.
, 1993
, “
Imaging Vector Fields Using Line Integral Convolution
,” Proceedings of the 20th Annual Conference on Computer Graphics and Interactive Techniques
, Anaheim, CA, Aug. 2–6, pp. 263
–270
.https://cs.brown.edu/courses/csci2370/2000/1999/cabral.pdf20.
Atcheson
,
B.
,
Heidrich
,
W.
, and
Ihrke
,
I.
, 2009
, “
An Evaluation of Optical Flow Algorithms for Background Oriented Schlieren Imaging
,” Exp. Fluids
,
46
(3
), pp. 467
–476
.10.1007/s00348-008-0572-721.
Cook
,
R. L.
, and
DeRose
,
T.
, 2005
, “
Wavelet Noise
,” ACM Trans. Graph.
,
24
(3
), pp. 803
–811
.10.1145/1073204.107326422.
Crameri
,
F.
,
Shephard
,
G. E.
, and
Heron
,
P. J.
, 2020
, “
The Misuse of Colour in Science Communication
,” Nat. Commun.
,
11
(1
), p. 5444
.10.1038/s41467-020-19160-723.
Brox
,
T.
,
Bruhn
,
A.
,
Papenberg
,
N.
, and
Weickert
,
J.
, 2004
, “
High Accuracy Optical Flow Estimation Based on a Theory for Warping
,” European Conference on Computer Vision
,
Springer
, Berlin, pp. 25
–36
.24.
Brown
,
J.
,
Gregson
,
F. K. A.
,
Shrimpton
,
A.
,
Cook
,
T. M.
,
Bzdek
,
B. R.
,
Reid
,
J. P.
, and
Pickering
,
A. E.
, 2020
, “
A Quantitative Evaluation of Aerosol Generation During Tracheal Intubation and Extubation
,” Anaesthesia
,
76
(2
), pp. 174
–181
.10.1111/anae.1529225.
Scharfman
,
B. E.
,
Techet
,
A. H.
,
Bush
,
J. W. M.
, and
Bourouiba
,
L.
, 2016
, “
Visualization of Sneeze Ejecta: Steps of Fluid Fragmentation Leading to Respiratory Droplets
,” Exp. Fluids
,
57
(2
), p. 24.10.1007/s00348-015-2078-426.
Pleil
,
J. D.
,
Wallace
,
M. G.
,
Davis
,
M. D.
, and
Matty
,
C. M.
, 2021
, “
The Physics of Human Breathing: Flow, Timing, Volume, and Pressure Parameters for Normal, on-Demand, and Ventilator Respiration
,” J. Breath Res.
,
15
(4
).10.1088/1752-7163/ac258927.
Carlon
,
G. C.
,
Ray
,
C.
,
Pierri
,
M. K.
,
Groeger
,
J.
, and
Howland
,
W. S.
, 1982
, “
High-Frequency Jet Ventilation
,” Chest
,
81
(3
), pp. 350
–354
.10.1378/chest.81.3.35028.
Burrer
,
S. L.
,
de Perio
,
M. A.
,
Hughes
,
M. M.
,
Kuhar
,
D. T.
,
Luckhaupt
,
S. E.
,
McDaniel
,
C. J.
,
Porter
,
R. M.
,
Silk
,
B.
,
Stuckey
,
M. J.
, and
Walters
,
M.
, 2020
, “
Characteristics of Health Care Personnel With COVID-19 — United States, February 12–April 9, 2020
,” Morb. Mortal. Wkly. Rep.
,
69
(15
), pp. 477
–481
.10.15585/mmwr.mm6915e629.
Knoetze
,
C.
, 2020
, “Protecting the Health Workers Who Protect us All
,” World Health Organization, Geneva, Switzerland.https://www.who.int/news-room/featurestories/detail/protecting-the-health-workers-who-protect-us-all30.
Fowler
,
R. A.
,
Guest
,
C. B.
,
Lapinsky
,
S. E.
,
Sibbald
,
W. J.
,
Louie
,
M.
,
Tang
,
P.
,
Simor
,
A. E.
, and
Stewart
,
T. E.
, 2004
, “
Transmission of Severe Acute Respiratory Syndrome During Intubation and Mechanical Ventilation
,” Am. J. Respir. Crit. Care Med.
,
169
(11
), pp. 1198
–1202
.10.1164/rccm.200305-715OC31.
Simonds
,
A. K.
,
Hanak
,
A.
,
Chatwin
,
M.
,
Morrell
,
M. J.
,
Hall
,
A.
,
Parker
,
K. H.
,
Siggers
,
J. H.
, and
Dickinson
,
R. J.
, 2010
, “
Evaluation of Droplet Dispersion During Non-Invasive Ventilation, Oxygen Therapy, Nebuliser Treatment and Chest Physiotherapy in Clinical Practice: Implications for Management of Pandemic Influenza and Other Airborne Infections
,” Health Technol. Assess.
,
14
(46
).10.3310/hta14460-0232.
Esquinas
,
A. M.
,
Pravinkumar
,
S. E.
,
Scala
,
R.
,
Gay
,
P.
,
Soroksky
,
A.
,
Girault
,
C.
,
Han
,
F.
,
Hui
,
D. S.
,
Papadakos
,
P. J.
, and
Ambrosino
,
N.
, 2014
, “
Noninvasive Mechanical Ventilation in High-Risk Pulmonary Infections: A Clinical Review
,” Eur. Respir. Rev.
,
23
(134
), pp. 427
–438
.10.1183/09059180.0000941333.
Thille
,
A. W.
,
Muller
,
G.
,
Gacouin
,
A.
,
Coudroy
,
R.
,
Decavèle
,
M.
,
Sonneville
,
R.
,
Beloncle
,
F.
, et al., 2019
, “
Effect of Postextubation High-Flow Nasal Oxygen With Noninvasive Ventilation vs High-Flow Nasal Oxygen Alone on Reintubation Among Patients at High Risk of Extubation Failure
,” JAMA
,
322
(15
), p. 1465
.10.1001/jama.2019.1490134.
Gormley
,
T.
, and
Wagner
,
J.
, 2018
, “Studying Airflow in the OR: Measuring the Environmental Quality Indicators in a Dynamic Hospital Operating Room Setting
”.https://www.hfmmagazine.com/articles/3246-studyingairflow-in-the-or35.
White
,
S. M.
, and
Chakladar
,
A.
, 2020
, “
Aerosols: Are Anaesthetists at Risk of COVID-19 or Not?
,” Anaesthesia
, 76, pp. 19
–20
.10.1111/anae.1533436.
Gralnek
,
I. M.
,
Hassan
,
C.
,
Beilenhoff
,
U.
,
Antonelli
,
G.
,
Ebigbo
,
A.
,
Pellisè
,
M.
,
Arvanitakis
,
M.
, et al., 2020
, “
ESGE and ESGENA Position Statement on Gastrointestinal Endoscopy and the COVID-19 Pandemic
,” Endoscopy
,
52
(06
), pp. 483
–490
.10.1055/a-1155-622937.
ECRI,
2020
, “Safety of Extended Use and Reuse of N95 Respirators
,” ECRI Clinical Evidence Assessment, ECRI, Plymouth Meeting, PA.https://www.elsevier.com/__data/assets/pdf_file/0006/997863/COVID-ECRI-N95-Respirators_2020-03.pdfCopyright © 2023 by ASME
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