Noninvasive ventilation in patients with COVID-19 from the perspective of the risk of contamination: a narrative review

Author(s)

Oliveira, Murilo Rezende ^[1] ; Back, Guilherme Dionir ^[1] ; Konzen, Vanessa de Mello ^[2] ; Garcia-Araujo, Adriana Sanches ^[1] ; Goulart, Cassia da Luz ^[1] ; Silva, Rebeca Nunes ^[1] ; Wibelinger, Lia Mara ^[2] ; Dixit, Snehil ^{[3, 4, 5]} ; Arena, Ross ^{[3, 4, 6]} ; Borghi-Silva, Audrey ^{[3, 1, 4]}

Affiliation

^[1] Univ Fed Sao Carlos, Physiotherapy Dept, Cardiopulm Physiotherapy Lab, UFSCar, Rodovia Washington Luis, KM 235, BR-13565905 Sao Carlos, SP - Brazil

^[2] Univ Passo Fundo, Physiotherapy Dept, UPF, Passo Fundo, RS - Brazil

^[3] Univ Illinois, Coll Appl Hlth Sci, Dept Phys Therapy, Chicago, IL - USA

^[4] Hlth Living Pandem Event Protect HI PIVOT Network, Chicago, IL - USA

^[5] King Khalid Univ, Coll Appl Med Sci, Dept Med Rehabil Sci, Abha - Saudi Arabia

^[6] Univ Illinois, Coll Appl Sci, Dept Phys Therapy, Chicago, IL - USA

• Document type: Review article
• Source: EXPERT REVIEW OF RESPIRATORY MEDICINE; v. 16, n. 1 DEC 2021.
• Web of Science Citations: 0

Abstract

Introduction noninvasive ventilation (NIV) can be a useful resource to treat acute respiratory failure (ARF), which occurs in patients with COVID-19. However, it is important to consider that there are still no clinical studies that have verified the safety of its use in increase of contamination. Areas covered Given the potential benefits and simultaneous concerns over the use of NIV in patients with COVID-19, further inquiry is necessary to reach a clinical consensus and provide recommendations for safe use, avoiding contamination. In this context, this narrative review, which included articles published in the Embase, SciELO, PEDro, PubMed and Cochrane up to August 2021, is focused to evaluate available studies related to interfaces, types of circuits, recommended filters, cares for the environment and protective factors for NIV use in patients with COVID-19. Expert Opinion The studies analyzed recommend that the use of NIV can be safe: 1) with equipment that allows the use of the helmet as a safer interface; 2) with double circuit and antimicrobial filter in the expiratory branch; 3) in an environment that allows negative pressure, reducing the dispersion of aerosol particles in the environment; 4) the health team must use the recommended PPE to avoid contamination. (AU)

• FAPESP's process: 18/03233-0 - Study of cardiorespiratory interaction and the supply of peripheral and cerebral oxygen as modulators of exercise capacity during bilevel application in the coexistence of COPD-CHF
• Grantee: Cássia da Luz Goulart
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)