High speed photography to determine the presence or absence of airborne droplets in the exhaled air of subjects wearing high flow nasal cannulae (OptiflowTM) with calculations of trajectory and drying time

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Humidified High Flow Nasal cannulae (Optiflow Trademark Fisher and Paykel Healthcare, Auckland, New Zealand) are in use in many clinical settings including the home and the hospital. These cannulae are used to deliver a range of flows of heated and humidified gases to support patients with a variety of conditions including those with a compromised respiratory status. It is thought that whilst patients are on this therapy that their exhaled gases laden with viral airborne droplets (aerosols) may lead to an increased infection control risk. Determining both the potential dispersal of viruses via aerosol and whether the use of a cannula generates more exhaled droplets compared to normal resting breathing and forced nasal exhalation (snorting), is vital as this shall help inform any control measures. The hypothesis under consideration was that Optiflow use does not pose an increased risk of Hospital Acquired Infections (HAI’s) from an infection prevention and control perspective.