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Aerosol generation and droplet spread during nasogastric intubation in the COVID-19 era
  1. Wout Verbeure1,
  2. Annelies Geeraerts1,
  3. I-Hsuan Huang1,2,
  4. Lien Timmermans3,
  5. Joran Toth1,
  6. Hannelore Geysen1,
  7. Louise Cools1,
  8. Florencia Carbone1,3,
  9. Jolien Schol1,
  10. Herman Devriese4,
  11. Rico Haesaerts3,
  12. Hideki Mori1,
  13. Tim Vanuytsel1,3,
  14. Jan Tack1,3
  1. 1 Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (ChroMeta), KU Leuven, Leuven, Belgium
  2. 2 Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan
  3. 3 Gastroenterology and Hepatology, KU Leuven University Hospitals, Leuven, Belgium
  4. 4 Prevention and Environment, KU Leuven University Hospitals, Leuven, Belgium
  1. Correspondence to Professor Jan Tack, Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases Metabolism and Ageing (ChroMetA), KU Leuven, Leuven 3000, Belgium; jan.tack{at}med.kuleuven.be

https://doi.org/10.1136/gutjnl-2020-323836

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    We read with interest the recent article by Repici et al who reported that gastrointestinal (GI) endoscopy seems relatively safe for medical staff wearing adequate protective measures, with 4.3% of 968 healthcare workers (HCW) in the endoscopy setting infected with COVID-19.1 Similar to GI endoscopy, oesophageal motility studies are common practice and potentially also high-risk medical procedures as COVID-19 may spread through generation of aerosols and droplets during insertion and removal of oesophageal high resolution manometry (HRM) and 24 hours multichannel intraluminal impedance-pH monitoring (pH-MII) probes.2 Current guidelines recommend high-level protection with N95 mask, Filtering FacePiece (FFP)2 or FFP3, double gloves, face shield and gown for HCW during oesophageal physiologic procedures to minimise the risk of transmission.3 4 However, there is a lack of scientific evidence on the spread of aerosols and droplets during nasogastric intubation. Therefore, we performed a prospective study, addressing these concerns.

    Patients with a negative COVID-19 test by PCR undergoing nasogastric intubation for HRM or pH-MII were included. During the procedures, patients wore a mask over the mouth and were seated in a lowered position in front of …

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