Pleural procedures such as chest drains and thoracoscopy do not need to be classed as aerosol generating in relation to transmission risk of SARS-CoV-2, say UK researchers.
A study looking at aerosol emissions in several pleural procedures found that in most procedures, the peak aerosol concentration was of similar magnitude to or less than the mean during breathing from the same patients or from healthy volunteers.
It was also significantly less than the peak aerosol concentration detected from a cough.
The Bristol researchers also found that percutaneous instrumentation of the pleura does not lead to significant aerosol generation.
In fact, total aerosol generation during these procedures was significantly below the number concentration produced by breathing or coughing.
The study was part of work being done by NIHR researchers as part of the AERATOR study.
British Thoracic Society guidelines had noted the absence of evidence but had been based on the precautionary principle suggesting that closed pleural procedures such as pleural aspirations and chest drain insertion could be done in level 1 PPE but that open procedures required level 2 PPE which is an FFP3 mask, long-sleeved gown, gloves and eye protection.