Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19 : a Living Systematic Review of Multiple Streams of Evidence
| Autor: | Anna Bak, Joel Schmidt, Rebecca Thomas, Tamara Lotfi, Paul Garner, Finn Schünemann, Layal Hneiny, Robby Nieuwlaat, Holger J. Schünemann, Anisa Hajizadeh, Andrea Darzi, Joanne Khabsa, Ariel Izcovich, Fatimah Chamseddine, Elie A. Akl, Jan Brozek, Nancy Santesso, Florian Stehling, Giovanna E. U. Muti-Schünemann, Wojciech Szczeklik, Ignacio Neumann, Rayane El-Khoury, Mark Loeb, Waleed Alhazzani, Ewa Borowiack, Derek K. Chu, Rosa Stalteri, Assem M. Khamis, Tejan Baldeh, Romina Brignardello-Petersen, Stephen Aston, Sally Yaacoub, Gian Paolo Morgano, Marge Reinap, Zahra Saad, Bram Rochwerg, Carlos A. Cuello-Garcia, Mats Junek, Eddy Fan, Dan Perri, Yuan Zhang, Antonio Bognanni, Imad Bou Akl, Karla Solo, Chen Chen, Guang Chen, Amena El-Harakeh, Hong Zhao, Thomas Piggott, Leila Harrison |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Pneumonia Viral Medizin Disease medicine.disease_cause Severe Acute Respiratory Syndrome World Health Organization 01 natural sciences 03 medical and health sciences Betacoronavirus 0302 clinical medicine Internal Medicine medicine Animals Humans 030212 general & internal medicine Letters 0101 mathematics Intensive care medicine Pandemics Coronavirus Randomized Controlled Trials as Topic Mechanical ventilation Aerosols business.industry SARS-CoV-2 010102 general mathematics COVID-19 General Medicine Update Alerts medicine.disease Respiration Artificial Pneumonia Systematic review Respiratory failure Breathing Middle East respiratory syndrome business Coronavirus Infections Systematic Reviews as Topic |
| Zdroj: | ANNALS OF INTERNAL MEDICINE Annals of Internal Medicine |
| Popis: | BACKGROUND: Mechanical ventilation is used to treat respiratory failure in coronavirus disease 2019 (COVID-19). PURPOSE: To review multiple streams of evidence regarding the benefits and harms of ventilation techniques for coronavirus infections, including that causing COVID-19. DATA SOURCES: 21 standard, World Health Organization-specific and COVID-19-specific databases, without language restrictions, until 1 May 2020. STUDY SELECTION: Studies of any design and language comparing different oxygenation approaches in patients with coronavirus infections, including severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS), or with hypoxemic respiratory failure. Animal, mechanistic, laboratory, and preclinical evidence was gathered regarding aerosol dispersion of coronavirus. Studies evaluating risk for virus transmission to health care workers from aerosol-generating procedures (AGPs) were included. DATA EXTRACTION: Independent and duplicate screening, data abstraction, and risk-of-bias assessment (GRADE for certainty of evidence and AMSTAR 2 for included systematic reviews). DATA SYNTHESIS: 123 studies were eligible (45 on COVID-19, 70 on SARS, 8 on MERS), but only 5 studies (1 on COVID-19, 3 on SARS, 1 on MERS) adjusted for important confounders. A study in hospitalized patients with COVID-19 reported slightly higher mortality with noninvasive ventilation (NIV) than with invasive mechanical ventilation (IMV), but 2 opposing studies, 1 in patients with MERS and 1 in patients with SARS, suggest a reduction in mortality with NIV (very-low-certainty evidence). Two studies in patients with SARS report a reduction in mortality with NIV compared with no mechanical ventilation (low-certainty evidence). Two systematic reviews suggest a large reduction in mortality with NIV compared with conventional oxygen therapy. Other included studies suggest increased odds of transmission from AGPs. LIMITATION: Direct studies in COVID-19 are limited and poorly reported. CONCLUSION: Indirect and low-certainty evidence suggests that use of NIV, similar to IMV, probably reduces mortality but may increase the risk for transmission of COVID-19 to health care workers. PRIMARY FUNDING SOURCE: World Health Organization. (PROSPERO: CRD42020178187). |
| Databáze: | OpenAIRE |
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