Respiratory failure & ventilation
Generation of Aerosols by Noninvasive Respiratory Support Modalities: A Systematic Review and Meta-Analysis
Authors' conclusion
This systematic review and meta-analysis found no association between high-flow nasal oxygen or noninvasive ventilation and increased airborne pathogen detection or aerosol generation.
Study context
- Population
- Patients or healthy volunteers supported with HFNO or NIV (observational and (quasi-)experimental studies)24 studies
- Comparison
- HFNO or NIV vs no such support
- Outcome
- Detection of pathogens in air samples and quantity of aerosol particles
Methodological detailsrandom-effects model, sample- and patient-level pooling, sensitivity analyses, 12 studies in patients, 15 in healthy volunteers
- Random-effects model
- Sample- and patient-level pooling
- Sensitivity analyses
- 12 studies in patients, 15 in healthy volunteers
Pooled result
As reported in the abstract
SARS-CoV-2 detection in air samples (OR for positive samples)
Odds ratio (95% CI)
HFNOsample level; 5 observational studies, 212 air samples, 152 patients with COVID-19
0.73(0.15–3.55)
HFNOpatient level
0.80(0.14–4.59)
NIVsample level; 2 studies, 84 air samples, 72 patients
0.38(0.03–4.63)
NIVpatient level
0.43(0.01–27.12)
Original publication
Generation of Aerosols by Noninvasive Respiratory Support Modalities: A Systematic Review and Meta-Analysis. JAMA Netw Open. Published 2 October 2023. doi:10.
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