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      Exhaled gases and the potential for cross-infection via noninvasive ventilation machines

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          Abstract

          Use of long-term ventilation (LTV) benefits patients with a diverse range of conditions, including Duchenne muscular dystrophy, motor neurone disease and scoliosis [1]. Patients with pulmonary disease as well as neuromuscular disease can benefit from LTV. COPD patients treated with LTV experience a reduction in hospital admissions and the use of LTV in cystic fibrosis (CF) patients is increasing [2, 3].

          Abstract

          Guidelines suggest that exhaled gases do not reach the outlet of noninvasive ventilators in clinical use. In this study, when tidal volumes exceeded 800 mL, exhaled gases did reach the ventilator, leading to a risk of cross-infection between users. https://bit.ly/3EdvtY6

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          Most cited references11

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          Effect of Home Noninvasive Ventilation With Oxygen Therapy vs Oxygen Therapy Alone on Hospital Readmission or Death After an Acute COPD Exacerbation : A Randomized Clinical Trial

          Patrick B. Murphy, Sunita Rehal, Gill Arbane … (2017)
          Outcomes after exacerbations of chronic obstructive pulmonary disease (COPD) requiring acute noninvasive ventilation (NIV) are poor and there are few treatments to prevent hospital readmission and death.
          Article 0 comments Cited 184 times – based on 0 reviews     Review now
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            Non-invasive ventilation in acute respiratory failure.

            (2002)
            Article 0 comments Cited 127 times – based on 0 reviews     Review now
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              The independent contribution of Pseudomonas aeruginosa infection to long-term clinical outcomes in bronchiectasis.

              Dusanka Obradovic, Stefano Aliberti, David Araújo … (2018)
              Pseudomonas aeruginosa is responsible for chronic infection in many bronchiectasis patients but it is not known whether it is associated with worse clinical outcomes independent of the underlying severity of disease.This study analysed data from 2596 bronchiectasis patients included from 10 different bronchiectasis clinical centres across Europe and Israel, with a 5-year follow-up period. Prevalence of P. aeruginosa chronic infection and its independent impact on exacerbations, hospitalisations, quality of life and mortality was assessed.The prevalence of P. aeruginosa chronic infection was 15.0% (n=389). P. aeruginosa was associated with a higher mortality in a univariate analysis (hazard ratio (HR) 2.02; 95% (confidence interval) CI 1.53-2.66; p<0.0001) but an independent impact on mortality was not found in a multivariate analysis (HR 0.98; 95% CI 0.70-1.36; p=0.89). P. aeruginosa was independently associated with increased mortality only in patients with frequent exacerbations (two or more per year) (HR 2.03; 95% CI 1.36-3.03; p=0.001). An independent association with worse quality of life of 7.46 points (95% CI 2.93-12.00; p=0.001) was found in a multivariable linear regression. P. aeruginosa was therefore found to be independently associated with exacerbation frequency, hospital admissions and worse quality of life. Mortality was increased in patients with P. aeruginosa particularly in the presence of frequent exacerbations.
              Article 0 comments Cited 63 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): ERJ Open Res
                Journal ID (iso-abbrev): ERJ Open Res
                Journal ID (publisher-id): ERJOR
                Journal ID (hwp): erjor
                Title: ERJ Open Research
                Publisher: European Respiratory Society
                ISSN (Electronic): 2312-0541
                Publication date Collection: July 2022
                Publication date (Electronic): 04 July 2022
                Volume: 8
                Issue: 3
                Electronic Location Identifier: 00109-2022
                Affiliations
                [1 ]The North East Assisted Ventilation Service, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK
                [2 ]Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
                [3 ]Newcastle Microbiology and Virology Services, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK
                Author notes
                Benjamin Messer ( ben.messer@ 123456nhs.net )
                Author information
                https://orcid.org/0000-0002-9954-6366
                Article
                Publisher ID: 00109-2022
                DOI: 10.1183/23120541.00109-2022
                PMC ID: 9251366
                SO-VID: 3d9b4019-8ab7-47ee-af88-9d8d1e4a2fa3
                Copyright © Copyright ©The authors 2022
                License:

                This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org

                History
                Date received : 26 February 2022
                Date accepted : 6 April 2022
                Categories
                Subject: Research Letters
                Subject: 4

                Data availability:

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