Controlling Spread of Viruses and High-Risk Infections to Hospital Health Care Workers from NIV

Abstract

Noninvasive positive-pressure ventilation (NIV) has been used successfully to treat acute respiratory failure arising from various conditions such as chronic obstructive pulmonary disease exacerbations, acute pulmonary edema, and pneumonia in immunocompromised patients [1]. There are debates on whether NIV should be considered a high-risk procedure that can be safely used for patients with respiratory infections [2]. NIV has been used to treat patients with respiratory failure due to severe acute respiratory syndrome [3, 4] and human H5N1 influenza infections [5, 6]. Spread of these infections to health care workers (HCWs) was reported [7]. The risk of such spread has been summarized in a systemic review, which estimated that the risk of transmission of infection from patients to HCWs from NIV are elevated with a pooled odds ratio of 3.1 (95 % confidence interval 1.4–6.8) from two studies in the review [8].