The use of non-invasive ventilation in COVID-19: A systematic review

Abstract

Objective Guidelines from different areas on the use of non-invasive ventilation in COVID-19 have generally been inconsistent. The goals were to appraise the quality and availability of guidelines stated and whether non-invasive ventilation in the early stage of the pandemic is of importance. Design and Method Databases including PubMed, Web of Science, Cochrane Library, and websites of international organizations and gray databases were searched up to June 23, 2020. We also hand-searched the reference lists of eligible papers. Results A total of 26 guidelines met the inclusion criteria. Regarding the appraisal by the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, the guidelines’ methodological quality was low. Among six domains, Rigour. of Development and Editorial Independence were of the lowest quality. Given the lack of evidence from randomized clinical trials and the great differences between different regions, non-invasive ventilation’s recommendations generated a considerable debate at the early stage of COVID-19. Conclusions Improving the methodological quality of the guidelines should be a goal in future pandemics. Additionally, more well-designed randomized clinical trials are needed to solve the controversy on the impact of non-invasive ventilation.

Investigating the Links Between Vaccination Against COVID-19 and Public Attitudes Toward Protective Countermeasures: Implications for Public Health

“…Consequently, the effect of vaccination against COVID-19 on wearing mask may be over-estimated. Third, ventilation is a primary control strategy for infectious diseases, which promotes the air dilution around a source and the removal of respiratory viruses (95). Recommendations have been introduced to reduce the transmission risk of virulent airborne viral particles by increasing ventilation rates, expressed in air-changes-perhour (ACH), effectively improving the dilution of airborne pathogens via mechanical ventilation (96).…”

Respiratory care for the critical patients with 2019 novel coronavirus

“…Along with the rapid progression of the epidemic and because of limited medical resources, clinical management has changed to support or conditional recommendation rather than a suggestion. However, clinical recommendations are relatively consistent on NIRS cross-over infection issues and emphasizing that attention must be paid during aerosol generating procedures [ 74 ]. Furthermore, prudent clinical judgment is needed during NIRS treatment and timely intubation should be considered if clinical conditions fail to improve [ 75 ].…”

A Pilot Study on Electrical Impedance Tomography During CPAP Trial in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia: The Bright Side of Non-invasive Ventilation

“…Hence, clinicians all over the world still have to face the impossibility to guarantee tracheal intubation for everyone (Grasselli et al, 2020), and non-invasive respiratory support becomes sometimes an obliged choice. Presently, an increasing amount of studies are reporting successful treatment of SARS-CoV-2 pneumonia in non-intubated patients, ventilated with moderate to high level of positive airways pressure (PEEP/CPAP) (8-12 cmH 2 O) and cycles of awake proning (Bamford et al, 2020;Whang et al, 2021). Accurate selection of patients, appropriate PEEP/CPAP setting, and correct timing for switching to invasive mechanical ventilation in non-responders to the non-invasive approach are thus of paramount importance and still remain among the most debated topics in the intensive care unit (ICU) environment and more (Lee et al, 2021;Tseng et al, 2021).…”