Triaging of respiratory protective equipment on the assumed risk of SARS-CoV-2 aerosol exposure in patient-facing healthcare workers delivering secondary care: a rapid review.
Triaging of respiratory protective equipment on the assumed risk of SARS-CoV-2 aerosol exposure in patient-facing healthcare workers delivering secondary care: a rapid review.
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DOI：
10.1136/bmjopen-2020-040321
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发表时间：
2020-10-16
期刊：
影响因子：
2.9
通讯作者：
Hettiaratchy S
中科院分区：
文献类型：
--
作者：
Ramaraj P;Super J;Doyle R;Aylwin C;Hettiaratchy S
在面向患者提供二级护理的医护人员中，英国政府关于外科口罩与呼吸器防护SARS-CoV-2的个人防护装备（PPE）指南的证据是什么？两名独立的审查人员进行了快速审查。评估采用关键评估技能计划核对表和建议、评估、发展和评估的分级方法进行。结果是通过比较发现和评价来综合的。MEDLINE，谷歌学者，英国政府COVID-19网站和灰色文献。包括在任何日期发表的含有比较SARS-CoV-2专用外科口罩和呼吸器的原始数据的研究，以及支持英国政府个人防护装备指导的研究。在鉴定出的30个口罩中，只有3个实验室研究发现了14种不同的呼吸器和12个外科口罩。在这三种情况下，在比较防护系数、还原系数、过滤器穿透率、不同粒径的吸入总泄漏量、平均吸入流量和呼吸速率时，呼吸器明显比口罩更有效。在人体和假人身上进行了活病毒和惰性颗粒的测试。在六项临床研究（6502名参与者）中，唯一有统计学意义的结果是，与有针对性地使用或外科口罩相比，持续使用呼吸器对临床呼吸系统疾病更有效。没有一致的“暴露”定义来确定呼吸防护设备（RPE）的功效。很难给“安全”下定义。针对SARS-CoV-2的口罩和呼吸器的比较证据不足，其他情况下的证据质量也很差。使用替代品可以推断非sars - cov -2特定数据，以指导英国政府的个人防护用品指导。鉴于SARS-CoV-2传播的不确定性，这种做法是否适当尚不清楚。这意味着英国政府个人防护装备指南的证据基础不是基于SARS-CoV-2，而是需要从其他病原体/颗粒的低质量证据中进行推广。关于SARS-CoV-2特异性RPE的有效性，缺乏高质量的证据。英国政府的个人防护装备指南基于SARS-CoV-2通过飞沫传播的假设。这些因素表明，过滤式3级口罩的分类可能会增加一些人面临的新冠肺炎风险。
In patient-facing healthcare workers delivering secondary care, what is the evidence behind UK Government personal protective equipment (PPE) guidance on surgical masks versus respirators for SARS-CoV-2 protection? Two independent reviewers performed a rapid review. Appraisal was performed using Critical Appraisal Skills Programme checklists and Grading of Recommendations, Assessment, Development and Evaluations methodology. Results were synthesised by comparison of findings and appraisals. MEDLINE, Google Scholar, UK Government COVID-19 website and grey literature. Studies published on any date containing primary data comparing surgical facemasks and respirators specific to SARS-CoV-2, and studies underpinning UK Government PPE guidance, were included. Of 30 identified, only 3 laboratory studies of 14 different respirators and 12 surgical facemasks were found. In all three, respirators were significantly more effective than facemasks when comparing protection factors, reduction factors, filter penetrations, total inspiratory leakages at differing particle sizes, mean inspiratory flows and breathing rates. Tests included live viruses and inert particles on dummies and humans. In the six clinical studies (6502 participants) included the only statistically significant result found continuous use of respirators more effective in clinical respiratory illness compared with targeted use or surgical facemasks. There was no consistent definition of ‘exposure’ to determine the efficacy of respiratory protective equipment (RPE). It is difficult to define ‘safe’. There is a paucity of evidence on the comparison of facemasks and respirators specific to SARS-CoV-2, and poor-quality evidence in other contexts. The use of surrogates results in extrapolation of non-SARS-CoV-2 specific data to guide UK Government PPE guidance. The appropriateness of this is unknown given the uncertainty over the transmission of SARS-CoV-2. This means that the evidence base for UK Government PPE guidelines is not based on SARS-CoV-2 and requires generalisation from low-quality evidence of other pathogens/particles. There is a paucity of high-quality evidence regarding the efficacy of RPE specific to SARS-CoV-2. UK Government PPE guidelines are underpinned by the assumption of droplet transmission of SARS-CoV-2. These factors suggest that the triaging of filtering face piece class 3 respirators might increase the risk of COVID-19 faced by some.
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影响因子：
--
作者：
Lee, Shu-An;Hwang, Dong-Chir;Chen, Jen-Kun
通讯作者：
Chen, Jen-Kun
DOI：
10.1164/rccm.201207-1164oc
发表时间：
2013-05-01
影响因子：
24.7
作者：
MacIntyre, C. Raina;Wang, Quanyi;Dwyer, Dominic E.
通讯作者：
Dwyer, Dominic E.
影响因子：
120.7
作者：
Loeb, Mark;Dafoe, Nancy;Walter, Stephen D.
通讯作者：
Walter, Stephen D.
DOI：
10.1016/j.jhin.2013.06.020
发表时间：
2013-11
期刊：
The Journal of hospital infection
影响因子：
--
作者：
Coia JE;Ritchie L;Adisesh A;Makison Booth C;Bradley C;Bunyan D;Carson G;Fry C;Hoffman P;Jenkins D;Phin N;Taylor B;Nguyen-Van-Tam JS;Zuckerman M;Healthcare Infection Society Working Group on Respiratory and Facial Protection
通讯作者：
Healthcare Infection Society Working Group on Respiratory and Facial Protection
影响因子：
--
作者：
Wells, WF
通讯作者：
Wells, WF