Diving suit: sterile, ambulatory, personal device for protective and preventive isolation of nosocomial invasive fungal infections in neutropenic patients hospitalised in laminar air flow room who need a disruption of isolation
Abstract number: r2110
Thiebaut A., Perraud M., Lyonnet D., Ozil S.
Patients with long neutropenia present high risk to develop invasive pulmonary aspergillosis (API) of poor prognosis. Pulmonary computed tomographic Scan (CT scan) allows earlier diagnosis of API and improve management in these patients (D. Caillot, JCO, 1997). However, CT scan need an isolation breaking which is potentially dangerous. We propose a diving suit to maintain the preventive isolation.
Materials and methods:
The diving suit is sterile, personal, ambulatory and transparent to permit monitoring, visual and conversational contact. It is supplied with air with a self-contained station of ventilation (12 hours). The air contamination is controlled with 2 HEPA filters. Fifteen patients treated for haematologic malignancies like acute leukaemia have tested it after giving inform consent.
The diving suit has been validated for air contamination, physiological (CO2), CT scan feasibility and patients acceptation. All patients (5 male, 10 females) presented a severe neutropenia (PMN <0.5 G/l during more than 10 days) at time of CT scan. Three patients have had already pulmonary CT scan before using diving suit and 2 claimed to be claustrophobic. No patient describe dyspnoea, neither pain nor discomfort. All patients felt reassured and agreed for a new CT scan with this clothing. Two patients have had another CT scan with diving suit for suspicion of pulmonary aspergillosis. Diving suit was very easy to manipulate and did not disrupt monitoring or treatments administration. Diving suit was also compatible with Doppler and Radio Magnetic Nuclear. For one of these patients with fever resistant to antibacterial treatment, 3 thoracic CT scan were performed (1 per week) without any sign of API. The fourth CT scan allowed the diagnosis of API with halo sign. This diagnosis has been demonstrated by histology after surgery. In this case report, contamination has not been possible during first CT scan because of the diving suit, this information is very important to explain to the patient and his family.
Pulmonary CT scan needs very often to be performed in neutropenic patients to assess API diagnosis. An ambulatory, personal protective clothing allows no disruption of isolation for immunocompromized patients during a CT scan. It can also be proposed for medical staff protection when treating patients with SARS or other highly contagious agents.
|Session name:||XXIst ISTH Congress|
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