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?:abstract
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Here, the authors examine the effect of high-flow aerosol-dispersing versus aerosol-generating procedures Hypoxemia is the main symptom and primary reason for hospital admission among patients with coronavirus disease (COVID-19), and oxygen therapy is the mainstay therapy to treat hypoxemia Among 10,054 patients with COVID-19 admitted to ICUs in the United Kingdom during the pandemic, more than 70% required advanced respiratory support, including high-flow nasal cannula (HFNC) oxygen therapy, noninvasive (NIV) and invasive ventilation, and extracorporeal membrane oxygenation HFNC and NIV have been categorized as aerosol-generating procedures, based on the hypothesis that high-velocity gas flows may promote aerosolization of patients\' secretions containing viable virus, which may then be dispersed in the environment and be inhaled by healthcare workers Indeed, retrospective studies assessing risk factors of nosocomial transmission of the severe acute respiratory syndrome (SARS) observed that healthcare workers caring for patients with SARS treated by NIV had a twofold higher risk of infection transmission than those who did not Furthermore, Gaeckle and colleagues provide evidence that the difference of the aerosol particle concentrations generated by various oxygenation devices is clinically insignificant and probably negligible, compared with the intersubject variability of patient-generated bioaerosols
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