Oxygen therapy and risk of infection for health care workers caring for patients with viral severe acute respiratory infection: A systematic review and meta-analysis
Autor
Cournoyer, Alexis
Grand’Maison, Sophie
Lonergan, Ann-Marie
Lessard, Justine
Chauny, Jean-Marc
Castonguay, Véronique
Marquis, Martin
Frégeau, Amélie
Huard, Vérilibe
Garceau-Tremblay, Zoé
Turcotte, Ann-Sophie
Piette, Éric
Paquet, Jean
Cossette, Sylvie
Féral-Pierssens, Anne-Laure
Leblanc, Renaud-Xavier
Martel, Valéry
Daoust, Raoul
Institución
Resumen
Study objective: To synthesize the evidence regarding the infection risk associated with different modalities of oxygen therapy
used in treating patients with severe acute respiratory infection. Health care workers face significant risk of infection when treating
patients with a viral severe acute respiratory infection. To ensure health care worker safety and limit nosocomial transmission of
such infection, it is crucial to synthesize the evidence regarding the infection risk associated with different modalities of oxygen
therapy used in treating patients with severe acute respiratory infection.
Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from January 1, 2000, to
April 1, 2020, for studies describing the risk of infection associated with the modalities of oxygen therapy used for patients with
severe acute respiratory infection. The study selection, data extraction, and quality assessment were performed by independent
reviewers. The primary outcome measure was the infection of health care workers with a severe acute respiratory infection.
Random-effect models were used to synthesize the extracted data.
Results: Of 22,123 citations, 50 studies were eligible for qualitative synthesis and 16 for meta-analysis. Globally, the quality of
the included studies provided a very low certainty of evidence. Being exposed or performing an intubation (odds ratio 6.48; 95%
confidence interval 2.90 to 14.44), bag-valve-mask ventilation (odds ratio 2.70; 95% confidence interval 1.31 to 5.36), and
noninvasive ventilation (odds ratio 3.96; 95% confidence interval 2.12 to 7.40) were associated with an increased risk of
infection. All modalities of oxygen therapy generate air dispersion.
Conclusion: Most modalities of oxygen therapy are associated with an increased risk of infection and none have been
demonstrated as safe. The lowest flow of oxygen should be used to maintain an adequate oxygen saturation for patients with
severe acute respiratory infection, and manipulation of oxygen delivery equipment should be minimized. [Ann Emerg Med.
2020;-:1-13.]