Oxygen Therapy and Risk of Infection for Health Care Workers Caring for Patients With Viral Severe Acute Respiratory Infection: A Systematic Review and Meta-analysis
| Autor: | Vérilibe Huard, Jean-Marc Chauny, Zoé Garceau-Tremblay, Véronique Castonguay, Sylvie Cossette, Sophie Grand’Maison, Amélie Frégeau, Éric Piette, Ann-Marie Lonergan, Valéry Martel, Alexis Cournoyer, Justine Lessard, Anne-Laure Feral-Pierssens, Jean Paquet, Martin Marquis, Raoul Daoust, Ann-Sophie Turcotte, Renaud-Xavier Leblanc |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Infectious Disease Transmission Patient-to-Professional medicine.medical_treatment Severe Acute Respiratory Syndrome Article 03 medical and health sciences 0302 clinical medicine Risk Factors Oxygen therapy Health care medicine Humans 030212 general & internal medicine Oxygen saturation (medicine) Cross Infection business.industry Risk of infection Oxygen Inhalation Therapy Respiratory infection 030208 emergency & critical care medicine Odds ratio Confidence interval Meta-analysis Emergency medicine Emergency Medicine business |
| Zdroj: | Annals of Emergency Medicine |
| ISSN: | 0196-0644 |
| DOI: | 10.1016/j.annemergmed.2020.06.037 |
| Popis: | STUDY OBJECTIVE: To synthesize the evidence regarding the infection risk associated with different modalities of oxygen therapy used in treating patients with severe acute respiratory infection. Health care workers face significant risk of infection when treating patients with a viral severe acute respiratory infection. To ensure health care worker safety and limit nosocomial transmission of such infection, it is crucial to synthesize the evidence regarding the infection risk associated with different modalities of oxygen therapy used in treating patients with severe acute respiratory infection. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from January 1, 2000, to April 1, 2020, for studies describing the risk of infection associated with the modalities of oxygen therapy used for patients with severe acute respiratory infection. The study selection, data extraction, and quality assessment were performed by independent reviewers. The primary outcome measure was the infection of health care workers with a severe acute respiratory infection. Random-effect models were used to synthesize the extracted data. RESULTS: Of 22,123 citations, 50 studies were eligible for qualitative synthesis and 16 for meta-analysis. Globally, the quality of the included studies provided a very low certainty of evidence. Being exposed or performing an intubation (odds ratio 6.48; 95% confidence interval 2.90 to 14.44), bag-valve-mask ventilation (odds ratio 2.70; 95% confidence interval 1.31 to 5.36), and noninvasive ventilation (odds ratio 3.96; 95% confidence interval 2.12 to 7.40) were associated with an increased risk of infection. All modalities of oxygen therapy generate air dispersion. CONCLUSION: Most modalities of oxygen therapy are associated with an increased risk of infection and none have been demonstrated as safe. The lowest flow of oxygen should be used to maintain an adequate oxygen saturation for patients with severe acute respiratory infection, and manipulation of oxygen delivery equipment should be minimized. |
| Databáze: | OpenAIRE |
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