Hui-Yun Tseng1, Yi-Ting Tsai2, Ying-Shiuan Su2, Po-Pei Peng2, Gwo-Hwa Wan This email address is being protected from spambots. You need JavaScript enabled to view it.2,3,4,5

1 Department of Respiratory Therapy, Fu Jen Catholic University, New Taipei City, Taiwan
2 Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
3 Department of Obstetrics and Gynaecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
4 Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan
5 Center for Environmental Sustainability and Human Health, Ming Chi University of Technology, Taishan, New Taipei, Taiwan


Received: November 5, 2023
Revised: January 9, 2024
Accepted: February 4, 2024

 Copyright The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are cited.


Download Citation: ||https://doi.org/10.4209/aaqr.230265  

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Cite this article:

Tseng, H.Y., Tsai, Y.., Su, Y.S., Peng, P.P., Wan, G.H. (2024). Drug Concentrations in the Air and their Influencing Factors in a Pediatric Intensive Care Unit. Aerosol Air Qual. Res. https://doi.org/10.4209/aaqr.230265


HIGHLIGHTS

  • VOC concentration in the intensive care unit exceeded the national standard.
  • Acetylcysteine concentration in the air was correlated with CO2 levels.
  • The drug concentration in the air decreased as the distance increased.
  • Maintaining a safe distance is crucial for minimizing drug exposure.
 

ABSTRACT


Aerosolized drug therapy is a common approach in treating respiratory diseases in clinical practice. This study aimed to assess air quality in the pediatric intensive care unit (PICU) of the medical center and investigate variations in drug concentration relative to the patient’s position during aerosolized drug treatment. To monitor air quality and aerosolized drug concentrations in the PICU, we conducted bi-weekly 24-hour samplings over a month. Monitored air quality parameters included temperature, relative humidity (RH), carbon dioxide (CO2), particulate matter (PM), total volatile organic compounds (TVOCs), and aerosolized drug levels in the air. The study also used a small volume nebulizer (SVN) to analyze the relationship between aerosolized drug concentration and distance from a simulated patient. This study revealed that the average concentrations of CO2, PM10 (an aerodynamic diameter equal to or less than 10 μm), and PM2.5 (an aerodynamic diameter less than 2.5 μm) in the PICU met Taiwan’s Ministry of Environment (MOENV) indoor air quality standards. However, the hourly average concentration of TVOCs in the PICU was almost twice the MOENV standard. The concentration of acetylcysteine in the air showed a positive association with both RH and CO2 concentration. Additionally, drug concentrations measured at 1 m, 1.6 m, and 3 m from the SVN were significantly lower than those measured at 0.1 m from the SVN. Continuous monitoring of TVOCs and CO2 in the PICU is necessary. During aerosol therapy, it is crucial for medical staff and family members to maintain a safe distance or integrate a HEPA (high-efficiency particulate air) filter into the ventilator circuit system. This precautionary step aims to minimize unwarranted exposure and maintain hospital air quality.


Keywords: Hospital, Air quality, Particulate matter, Volatile organic compound, Airborne drug, Aerosol therapy




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