Invasive ventilator exhaust in critical care: aerosol transmission risks and management strategies-a narrative review.

ABSTRACT: Invasive mechanical ventilation (IMV) is essential in intensive care, yet aerosols released with ventilator exhaust remain an under-recognized source of airborne transmission and occupational exposure. This review outlines how exhaust-borne aerosols are generated and dispersed in clinical workflows, with amplification during airway suctioning, therapeutic nebulization, and inhaled volatile sedation. We compare principal mitigation options-including heat-and-moisture exchanger (HME) devices and high-efficiency particulate air filtration (HEPA), directed discharge, and chemical inactivation-across effectiveness, operational complexity, adaptability, and strength of evidence. Building on a patient-device-environment framework, we propose a scenario-based, three-tier prevention strategy that a

SUBMITTER: Shi A 

PROVIDER: S-EPMC12690880 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature