Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Sao Carlos, Brazil.
Physiotherapy Department, University of Passo Fundo, UPF, Passo Fundo, Brazil.
Expert Rev Respir Med. 2022 Jan;16(1):67-77. doi: 10.1080/17476348.2021.2011223. Epub 2021 Dec 27.
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.
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.
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.
无创通气（NIV）可以成为治疗 COVID-19 患者急性呼吸衰竭（ARF）的有用资源。然而，重要的是要考虑到，目前还没有临床研究证实其在增加污染方面的使用安全性。
鉴于 NIV 在 COVID-19 患者中的使用具有潜在益处，同时也存在一些担忧，因此需要进一步研究以达成临床共识，并为安全使用提供建议，避免污染。在这种情况下，这篇叙述性综述纳入了截至 2021 年 8 月在 Embase、SciELO、PEDro、PubMed 和 Cochrane 上发表的文章，旨在评估与 COVID-19 患者使用 NIV 相关的接口、回路类型、推荐的过滤器、环境护理和防护因素的现有研究。
分析的研究表明，NIV 的使用是安全的：1）使用允许使用头盔作为更安全接口的设备；2）在呼气支路上使用双回路和抗菌过滤器；3）在允许负压的环境中，减少气溶胶颗粒在环境中的扩散；4）卫生团队必须使用推荐的个人防护装备以避免污染。
