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Generation of Aerosols by Noninvasive Respiratory Support Modalities: A Systematic Review and Meta-Analysis

Madeline X Zhang1, Thijs A Lilien2, Faridi S van Etten-Jamaludin3

  • 1Institute of Physics, Van der Waals-Zeeman Institute, University of Amsterdam, Amsterdam, the Netherlands.

JAMA Network Open
|October 11, 2023
PubMed
Abstract

Insights

High-flow nasal oxygen and noninvasive ventilation are not associated with increased airborne pathogen detection or aerosol generation. These findings suggest current infection control practices for these procedures may not need differentiation.

Area of Science:

  • Respiratory Medicine
  • Infectious Disease Control
  • Pulmonary Physiology

Background:

  • Historically, high-flow nasal oxygen (HFNO) and noninvasive ventilation (NIV) have been classified as aerosol-generating procedures (AGPs).
  • This classification necessitates specialized infection prevention and control (IPC) measures.
  • The evidence supporting this classification requires re-evaluation.

Conclusions:

  • This systematic review and meta-analysis found no evidence to support classifying HFNO or NIV as AGPs.
  • The findings suggest that current IPC practices differentiating these modalities may not be necessary.
  • Further research may refine understanding of aerosol generation during respiratory support.

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