SAVE-Study of Aerosol Generation for Virus-free Endoscopy [COVID-19]
Research type
Research Study
Full title
SAVE- Study of Aerosol generation for Virus-free Endoscopy
IRAS ID
285595
Contact name
Adolfo Parra-Blanco
Contact email
Sponsor organisation
Nottingham University Hospitals NHS Trust
Duration of Study in the UK
0 years, 5 months, 28 days
Research summary
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had a profound impact on how we practice medicine. A 12-fold increased risk of COVID-19 infection have been reported in healthcare workers (HCWs), risking further spread, loss of service provision, morbidity and mortality. A major cause for transmission is thought to be aerosol-generating procedures (AGPs), an area recognised by The World Health Organisation as a priority for research. \n\nGastrointestinal endoscopy is a major health service activity, with over 2 million procedures performed in the NHS each year. It has been deemed an AGP, so safety measures have been widely implemented, including patient prioritization, higher levels of personal protective equipment (PPE) and increased air recycling in rooms where endoscopy is performed. This has resulted in a drastically reduced capacity, which will lead to significant health repercussions on how we detect and manage gastrointestinal cancers and other important conditions. Practice between units is highly variable leading to healthcare discrepancies based on local practice. In addition, the higher levels of PPE lead to increased procedure times, reduced visual clarity, endoscopy staff discomfort and dehydration, hampered communication with the team, and excess plastic waste. Requirements for room ventilation have often led to changes in venues, and abandoning of poorly ventilated endoscopy suites. \n\nDespite the implications on safety, cost and capacity, there has been no quantitative research in quantifying aerosol generation at all, let alone how differences to technique and procedural modifications can attenuate aerosol generation. Clear evidence is needed quickly, which will inform NHS and WHO guidance on the use of PPE, equipment and room decontamination during endoscopy, procedure modifications to reduce aerosol generation, and risk stratification and prioritisation of endoscopy patients. The results will immediately influence how endoscopists conduct procedures and will have impact beyond the COVID-19 pandemic. \n
REC name
Wales REC 1
REC reference
20/WA/0229
Date of REC Opinion
1 Sep 2020
REC opinion
Further Information Favourable Opinion