Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19 A Living Systematic Review of Multiple Streams of Evidence

被引：87

作者：

Schunemann, Holger J. ^{[1
]}

Khabsa, Joanne ^{[2
]}

Solo, Karla ^{[1
]}

Khamis, Assem M. ^{[3
]}

Brignardello-Petersen, Romina ^{[1
]}

El-Harakeh, Amena ^{[2
]}

Darzi, Andrea ^{[1
]}

Hajizadeh, Anisa ^{[1
]}

Bognanni, Antonio ^{[1
]}

Bak, Anna ^{[4
]}

Izcovich, Ariel ^{[5
]}

Cuello-Garcia, Carlos A. ^{[1
]}

Chen, Chen ^{[6
]}

Borowiack, Ewa ^{[4
]}

Chamseddine, Fatimah ^{[2
]}

Schunemann, Finn ^{[1
]}

Morgano, Gian Paolo ^{[1
]}

Muti-Schunemann, Giovanna E. U. ^{[7
]}

Chen, Guang ^{[8
]}

Zhao, Hong ^{[9
]}

Neumann, Ignacio ^{[10
]}

Brozek, Jan ^{[1
]}

Schmidt, Joel ^{[1
]}

Hneiny, Layal ^{[2
]}

Harrison, Leila ^{[1
]}

Reinap, Marge ^{[11
]}

Junek, Mats ^{[1
]}

Santesso, Nancy ^{[1
]}

El-Khoury, Rayane ^{[2
]}

Thomas, Rebecca ^{[12
]}

Nieuwlaat, Robby ^{[1
]}

Stalteri, Rosa ^{[1
]}

Yaacoub, Sally ^{[2
]}

Lotfi, Tamara ^{[1
]}

Baldeh, Tejan ^{[1
]}

Piggott, Thomas ^{[1
]}

Zhang, Yuan ^{[1
]}

Saad, Zahra ^{[2
]}

Rochwerg, Bram ^{[1
]}

Perri, Dan ^{[1
]}

Fan, Eddy ^{[13
]}

Stehling, Florian ^{[14
]}

Akl, Imad Bou ^{[2
]}

Loeb, Mark ^{[1
]}

Garner, Paul ^{[12
]}

Aston, Stephen ^{[15
]}

Alhazzani, Waleed ^{[1
]}

Szczeklik, Wojciech ^{[16
]}

Chu, Derek K. ^{[1
]}

Akl, Elie A. ^{[2
]}

机构：

[1] McMaster Univ, HSC-2C,1280 Main St West, Hamilton, ON L8N 3Z5, Canada

[2] Amer Univ Beirut, Med Ctr, Beirut 11072020, Lebanon

[3] Univ Hull, Cottingham Rd, Kingston Upon Hull HU6 7RX, East Riding Of, England

[4] Evidence Prime, Torunska 5, PL-30056 Krakow, Poland

[5] German Hosp Buenos Aires, Pueyrredon 1640,C1118 AAT, Buenos Aires, DF, Argentina

[6] Guangzhou Univ Chinese Med, Jichang Rd 12, Guangzhou, Guangdong, Peoples R China

[7] Univ Vita Salute San Raffaele, Via Olgettina Milano 58, I-20132 Milan, Italy

[8] Beijing Univ Chinese Med, 5 HaiYun Cang, Beijing, Peoples R China

[9] China Acad Chinese Med Sci, Inst Acupuncture & Moxibust, 16 Nanxiaojie St, Beijing, Peoples R China

[10] Pontificia Univ Catolica Chile, Alameda 340, Santiago, Chile

[11] London Sch Hyg & Trop Med, Keppel St, London WC1E 7HT, England

[12] Univ Liverpool Liverpool Sch Trop Med, Dept Clin Sci, Liverpool L3 5QA, Merseyside, England

[13] Toronto Gen Hosp, 585 Univ Ave,PMB 11-123, Toronto, ON M5G 2N2, Canada

[14] Univ Essen Gesamthsch, Abt Padiat Pneumol, Klin Kinderheilkunde 3, Hufelandstr 55, D-45147 Essen, Germany

[15] Liverpool Univ Hosp NHS Trust, Trop & Infect Dis Unit, Prescot St, Liverpool L7 8XP, Merseyside, England

[16] Jagiellonian Univ Med Coll, Dept Intens Care & Perioperat Med, Krakow, Poland

来源：

ANNALS OF INTERNAL MEDICINE | 2020年 / 173卷 / 03期

关键词：

FLOW NASAL CANNULA; CONVENTIONAL OXYGEN-THERAPY; ACUTE RESPIRATORY SYNDROME; HEALTH-CARE WORKERS; ENDOTRACHEAL INTUBATION; NONINVASIVE VENTILATION; MECHANICAL VENTILATION; FAILURE; GRADE; PRESSURE;

D O I：

10.7326/M20-2306

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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)

引用

页码：204 / +

页数：14

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