A novel biocontainment unit that uses negative pressure to filter out viral particles during intubation procedure can limit exposure to SARS-CoV-2, according to a new study.

Researchers at the U.S. Army CCDC Army Research Laboratory (Aberdeen Proving Ground, MD, USA), the University of Pittsburgh Medical Center (UPMC, PA, USA), and other institutions conducted tests of a commercial passive protective enclosure (also known as an intubation box) to evaluate and compare it to a modified intubation biocontainment unit (IBU) with an active air filtration vacuum system. Three experts reviewed both during simulated intubations and negative-pressure isolation using visual smoke pattern analysis, aerosol leak testing, and air velocity measurements.

The results, as confirmed by qualitative evaluation, revealed smoke escaping from all passive enclosure openings, while the aerosol leak test showed elevated particle concentrations outside of the enclosure during simulated intubations with a medical mannequin. In contrast, when they tested the vacuum air filter equipped IBU enclosures, the visible smoke was fully contained, and test aerosols met standards consistent with class I biosafety cabinet certification. The study was published on September 3, 2020, in Annals of Emergency Medicine.

“The ability to isolate COVID-19 patients at the bedside is key to stopping viral spread in medical facilities and onboard military ships and aircraft, particularly to limit transmission through close quarters or shared ventilation systems,” said co-lead author Cameron Good, PhD, of UPMC. “When we tested the passive intubation box, we observed more than three times the aerosol concentration outside the box—where the healthcare provider is located—than inside the box. It is not safe to use these intubation boxes without actively filtering the air.”

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