Classification of aerosol-generating procedures: a rapid systematic review.
Classification of aerosol-generating procedures: a rapid systematic review.
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DOI：
10.1136/bmjresp-2020-000730
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发表时间：
2020-10
影响因子：
4.1
通讯作者：
Straube S
中科院分区：
文献类型：
--
作者：
Jackson T;Deibert D;Wyatt G;Durand-Moreau Q;Adisesh A;Khunti K;Khunti S;Smith S;Chan XHS;Ross L;Roberts N;Toomey E;Greenhalgh T;Arora I;Black SM;Drake J;Syam N;Temple R;Straube S
在2019冠状病毒病的背景下，气溶胶生成程序被强调为需要更高级别的个人防护设备。我们调查了官方指导文件和学术出版物如何根据是否产生气溶胶对程序进行分类。我们使用系统性综述和荟萃分析标准的首选报告项目进行了快速系统性综述。以英文或法文发表的指导气溶胶生成程序的准则、政策文件和学术论文有资格获得资助。我们在2020年3月和4月系统检索了两个医学数据库（medline、科克伦中心）和一个公共搜索引擎（google）。提取了关于每个程序如何按每个来源分类的数据。我们确定了每个手术组在不同指南中的一致性水平，根据其分类为气溶胶生成，可能的气溶胶生成或非气溶胶生成。128份文件符合我们的纳入标准;它们包含1248项程序，我们将其分为39个程序组。≥90%的文件归类为气溶胶生成或可能气溶胶生成的程序包括尸检、使用高速器械的手术/尸检程序、插管和拔管程序、支气管镜检查、痰诱导、手动通气、气道抽吸、心肺复苏、气管切开术和气管切开术程序、无创通气、高流量氧疗、打破封闭式通气系统、雾化或气雾剂治疗、和高频振荡通气。在一些手术组的来源之间存在分歧，包括口腔和牙科手术、上消化道内窥镜检查、胸外科手术和手术以及鼻咽和口咽拭子。有足够的证据表明，不同的国际指南一致同意将某些手术组归类为气溶胶生成。然而，令人惊讶的是，在我们的源文件中很少提到一些临床相关的程序。为了减少对其余部分的异议，我们建议（a）临床医生更明确和具体地定义程序，尽可能将其分解为组成部分;（B）研究人员在这些程序中进行进一步的雾化研究;（c）制定指南和决策机构解决更广泛的程序。
In the context of covid-19, aerosol generating procedures have been highlighted as requiring a higher grade of personal protective equipment. We investigated how official guidance documents and academic publications have classified procedures in terms of whether or not they are aerosol-generating. We performed a rapid systematic review using preferred reporting items for systematic reviews and meta-analyses standards. Guidelines, policy documents and academic papers published in english or french offering guidance on aerosol-generating procedures were eligible. We systematically searched two medical databases (medline, cochrane central) and one public search engine (google) in march and april 2020. Data on how each procedure was classified by each source were extracted. We determined the level of agreement across different guidelines for each procedure group, in terms of its classification as aerosol generating, possibly aerosol-generating, or nonaerosol-generating. 128 documents met our inclusion criteria; they contained 1248 mentions of procedures that we categorised into 39 procedure groups. Procedures classified as aerosol-generating or possibly aerosol-generating by ≥90% of documents included autopsy, surgery/postmortem procedures with high-speed devices, intubation and extubation procedures, bronchoscopy, sputum induction, manual ventilation, airway suctioning, cardiopulmonary resuscitation, tracheostomy and tracheostomy procedures, non-invasive ventilation, high-flow oxygen therapy, breaking closed ventilation systems, nebulised or aerosol therapy, and high frequency oscillatory ventilation. Disagreements existed between sources on some procedure groups, including oral and dental procedures, upper gastrointestinal endoscopy, thoracic surgery and procedures, and nasopharyngeal and oropharyngeal swabbing. There is sufficient evidence of agreement across different international guidelines to classify certain procedure groups as aerosol generating. However, some clinically relevant procedures received surprisingly little mention in our source documents. To reduce dissent on the remainder, we recommend that (a) clinicians define procedures more clearly and specifically, breaking them down into their constituent components where possible; (b) researchers undertake further studies of aerosolisation during these procedures; and (c) guideline-making and policy-making bodies address a wider range of procedures.
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DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
5.5
作者：
Knowlton, Samantha D.;Boles, Corey L.;Nonnenmann, Matthew W.
通讯作者：
Nonnenmann, Matthew W.
DOI：
10.1080/15459624.2012.725986
发表时间：
2012-01-01
影响因子：
2
作者：
Lindsley, William G.;King, William P.;Szalajda, Jonathan V.
通讯作者：
Szalajda, Jonathan V.
影响因子：
13.2
作者：
Smither, Sophie J.;Eastaugh, Lin S.;Lever, Mark S.
通讯作者：
Lever, Mark S.
DOI：
10.1089/jam.1997.10.105
发表时间：
1997-01-01
期刊：
Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine
影响因子：
--
作者：
Papineni, R S;Rosenthal, F S
通讯作者：
Rosenthal, F S