Diving Suit: Sterile, Ambulatory, Personnal Device for Protective and Preventive Isolation of Nosocomial Invasive Fungal Infections (IFI) in Neutropenic Patients Hospitalised in Laminar Air Flow Room Who Need a Disruption of Isolation.

BACKGROUND : 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.

MATERIAL AND METHODS : The diving suit is sterile, personnal, 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. Fithteen patients treated for hematologic malignancies like acute leukaemia have tested it after giving inform consent.

RESULTS : 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 dyspnea, either pain nor discomfort. All patients feelt 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.

CONCLUSION : Pulmonary CT scan needs very often to be performed in neutropenic patients to assess API diagnosis. An ambulatory, personnal 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.