The pathogenicity of the SARS-CoV-2 coronavirus has been well established over the past few months. While the virus' potency has led to the postponing of optional surgical procedures across the globe, some life-saving and emergency procedures on COVID-19 patients are unavoidable. In an innovative research involving Rolls-Royce, scientists have found a novel use for the cutting-edge tests used by the automaker to evaluate its jet engines—making operation theaters safe using high-speed cameras.
The ongoing study—which is led by University Hospitals of Derby and Burton NHS Foundation Trust (UHDB), along with the carmaker—is focused on understanding how droplets may disperse in the air during Aerosol Generating Procedures (AGPs) such as tracheostomies. For this, the research is employing high-speed cameras that capture 8,000 frames per second to record the tiniest of droplets in the air.
"We test our engines and components to the limit, using high-speed cameras to capture incredible levels of detail. Working with patients instead of jet engines was very different to our day job, but it's great that we've been able to apply our technology to help keep NHS staff safer while treating patients," said Eve George, Imaging Engineer at Rolls-Royce, in a statement.
Making Emergency Procedures Safer to Perform
AGPs refers to procedures that generate droplets of liquids that get diffused in the air. These droplets may contain pathogens such as the SARS-CoV-2. One of the most common surgical procedures conducted on COVID-19 patients is tracheostomy. The procedure involves the creation of an opening in the neck for the placement of a tube inside a patient's windpipe. This helps air enter the lungs directly and helps the individual breathe.
"Many of the patients for this trial are having so much difficulty with breathing that they transferred to our Intensive Care Unit and after a while, it can become necessary to perform a tracheostomy to aid the patient with their breathing and this is particularly common in COVID-19 patients," highlighted Dr. Bindy Sahota, lead researcher of the study.
Therefore, the research, which is known as Rapid Video Recording of Aerosol Generating Procedures (RVR-AGP), is aimed at discovering the distances to which particles can travel and how long they can linger in the air. This can thereby help make operating theaters safer for all the clinicians involved in the procedure.
Advanced Jet-testing Method for Safer Operating Theaters
RVR-AGP examines tracheostomy procedures employing high-speed cameras and light diffusers that are manned by technicians from Rolls-Royce, and capture the maximum extent to which the droplets travel through the air. This particular technology is used by the luxury automobile maker to conduct high-speed tests on jet engines.
With the ability to capture 8,000 frames per second, the camera aids the analyst in creating a more three-dimensional comprehension of how far droplets can travel in the air. After recording a procedure, the data is shared with Lancaster University for further analysis. Dr. Emma Stubington, Senior Research Associate at Lancaster University's Medical School, examines all the images. Then Dr. Stubington converts the droplet spread pattern into figures in order to identify changes.
"When you look at the images before I've started to work on them, you can't see anything as the droplets are so small and far too minute to see with the naked eye. The movement of droplets can be identified by looking at the changes in light intensity between each photograph. We're looking for such tiny changes and there's lots of movement in surgery so it makes things quite difficult," explained Dr. Stubington.
Showing Positive Results
The study is set to continue at least for a year before inferences are arrived upon, and improvements to the manner in which operating theaters function can be made. Thomas Stubington of UHDB stated: "We aim to record enough procedures to be able to give us an insight into the droplet production and hopefully suggest which methods of performing the procedure are safest."
In spite of being in its initial stages, the study has yielded positive results said Dr. Owen Judd, co-lead for the study. "Preliminary results have already suggested that our adapted surgical technique for performing tracheostomies has reduced the aerosol generated in the standard technique," he noted.
