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Noninvasive mechanical ventilation in high-risk pulmonary infections: a clinical review
Antonio M Esquinas1, S Egbert Pravinkumar2, Raffaele Scala2
1Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain. Dept of Critical Care, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA. Pulmonary and Respiratory Intensive Care Unit, S. Donato Hospital, Arezzo, Italy. Dept of Pulmonary, Critical Care and Sleep Medicine, Mayo Clinic, Rochester, MN, USA. General Intensive Care Unit, Assaf Harofeh Medical Center, Ramat Aviv, Israel. Dept of Medical Intensive Care, Charles Nicolle Rouen University Hospital, UPRES EA 3830-IRIB, Institute for Biomedical Research, Rouen University, Rouen, France. Dept of Pulmonary Medicine, The People's Hospital, Beijing University, Beijing, China. Dept of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China. Critical Care, University of Rochester, Rochester NY, USA. Pulmonary and Respiratory Intensive Care Unit, Cardio-Thoracic Dept, University Hospital Pisa, Pisa, Italy. For a full list of the International NIV Network collaborators see the Acknowledgements antmesquinas@gmail.com.
Abstract:
The aim of this article was to review the role of noninvasive ventilation (NIV) in acute pulmonary infectious diseases, such as severe acute respiratory syndrome (SARS), H1N1 and tuberculosis, and to assess the risk of disease transmission with the use of NIV from patients to healthcare workers. We performed a clinical review by searching Medline and EMBASE. These databases were searched for articles on "clinical trials" and "randomised controlled trials". The keywords selected were non-invasive ventilation pulmonary infections, influenza-A (H1N1), SARS and tuberculosis. These terms were cross-referenced with the following keywords: health care workers, airborne infections, complications, intensive care unit and pandemic. The members of the International NIV Network examined the major results regarding NIV applications and SARS, H1N1 and tuberculosis. Cross-referencing mechanical ventilation with SARS yielded 76 studies, of which 10 studies involved the use of NIV and five were ultimately selected for inclusion in this review. Cross-referencing with H1N1 yielded 275 studies, of which 27 involved NIV. Of these, 22 were selected for review. Cross-referencing with tuberculosis yielded 285 studies, of which 15 involved NIV and from these seven were selected. In total 34 studies were selected for this review. NIV, when applied early in selected patients with SARS, H1N1 and acute pulmonary tuberculosis infections, can reverse respiratory failure. There are only a few reports of infectious disease transmission among healthcare workers.
Insights
Noninvasive ventilation (NIV) can reverse respiratory failure in patients with severe acute respiratory syndrome (SARS), H1N1, and tuberculosis. Disease transmission risks to healthcare workers using NIV are minimal, with few reported cases.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Critical Care
Background:
- Noninvasive ventilation (NIV) is a critical respiratory support method.
- Acute pulmonary infectious diseases like SARS, H1N1, and tuberculosis pose significant public health challenges.
- Understanding NIV's efficacy and safety in these conditions is crucial for patient outcomes and healthcare worker protection.
Purpose of the Study:
- To review the role of NIV in managing acute pulmonary infectious diseases.
- To assess the risk of disease transmission from patients to healthcare workers during NIV use.
- To synthesize evidence on NIV application in SARS, H1N1, and tuberculosis.
Main Methods:
- A systematic clinical review was conducted using Medline and EMBASE databases.
- Searched for clinical trials and randomized controlled trials focusing on NIV for pulmonary infections.
- Keywords included NIV, pulmonary infections, SARS, H1N1, tuberculosis, and healthcare worker safety.
Main Results:
- Early application of NIV in selected patients with SARS, H1N1, and tuberculosis can effectively reverse respiratory failure.
- A total of 34 studies were selected for review, analyzing NIV's impact on these specific infections.
- Evidence suggests a low risk of infectious disease transmission to healthcare workers when using NIV.
Conclusions:
- NIV is a valuable tool for managing respiratory failure in acute pulmonary infections.
- The risk of NIV-related disease transmission to healthcare workers appears to be low.
- Further research may refine NIV protocols for infectious respiratory diseases and enhance patient safety.
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