COVID-19 Aerosol in EGD Using a Droplet Reduction Mouthpiece

Study Overview
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Brief Summary
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Measurement of aerosolisation during esophagogastroduodenoscopy (EGD) to compare two types of mouthpieces, conventional versus a new and commercially available one 'the droplet reduction mouthpiece B1'. This new mouthpiece is considered to reduce droplet spreading during EGD and therefore could be a good option for use in COVID-19 positive patients.

Detailed Description
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During esophagogastroduodenoscopy (EGD), a hard-plastic mouthpiece is used to protect the endoscope from being bitten and to enable its smooth insertion. In September 2020, the droplet reduction Mouthpiece B1 (Mouthpiece MPC-ST GMDN:62534 Generic name: Endoscopic bite block, basic, reusable) was launched by Fujifilm Corporation, Tokyo, Japan and imported to Europe by Fujifilm Europe. The droplet reduction mouthpiece is used in the same way as the conventional mouthpiece but differs from current mouthpieces by the inclusion of a sponge rubber incorporated into the mouthpiece orifice, and a drape shield specifically created to catch and reduce the droplets emitted by the patient during upper gastrointestinal endoscopy. This newly developed mouthpiece is considered for application during routine endoscopy at our facility during the COVID-19 pandemic, helping to minimize the risk to health care workers and patients from becoming infected with COVID-19 and various other pathogens. However, there is a lack of scientific evidence on the amount of aerosol reduction with the modified mouthpiece when upper gastrointestinal (GI) endoscopy is being performed. The aim of the present study is to quantify the generation of aerosols when performing upper GI endoscopy with the modified mouthpiece. The investigators intend to quantify the number of particles in the air near the patient. The duration of therapeutic upper gastrointestinal endoscopies can vary extremely. To avoid risk of imbalance in procedure durations, the investigational team is limiting the protocol to standard diagnostic EGDs. The investigators assume that aerosol generations during short procedures can be extrapolated to longer procedures and hence this should not invalidate the findings

Official Title
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COVID-19: a Study About Aerosol Formation During Gastroscopy With a Adjusted Mouthpiece for Droplet Reduction

Conditions
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Droplet Spread, Covid19

Intervention / Treatment
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* Device: Mouthpiece B1(Mouthpiece MPC-ST GMDN:62534 Generic name: Endoscopic bite block, basic, reusable


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged >18 years old; Male or female patients; Patients undergoing elective standard diagnostic EGD; Negative polymerase chain reaction (PCR) test on nasopharyngeal swab 24 or 48 hours prior to the test; No anatomical deformity of nose and throat, no known diseases of nose and throat; Signed informed consent Exclusion Criteria: Females who are pregnant or lactating.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: A investigator-initiated single center open-label randomized trial
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Conventional mouthpiece<br>Patients undergoing standard EGD using a conventional mouthpiece | Device: Mouthpiece B1(Mouthpiece MPC-ST GMDN:62534 Generic name: Endoscopic bite block, basic, reusable<br>* Use of a Mouthpiece B1 during standard EGD instead of a conventional mouthpiece<br>|
| Active Comparator: Droplet reduction mouthpiece<br>Patients undergoing standard EGD using a new droplet reduction mouthpiece | Device: Mouthpiece B1(Mouthpiece MPC-ST GMDN:62534 Generic name: Endoscopic bite block, basic, reusable<br>* Use of a Mouthpiece B1 during standard EGD instead of a conventional mouthpiece<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Generation of aerosol particles by esophagogastroduodenoscopy with the droplet reduction mouthpiece. | Number of aerosols generated by EGD with the droplet reduction mouthpiece | 4 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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droplet reduction mask, COVID-19, upper GI endoscopy