Comparison between technical parameters recommended by regulatory agencies and relevant institutions for ventilatory therapy equipment used in patients with COVID-19

Abstract

BackgroundPatients contaminated with the new coronavirus, SARS-CoV-2, and who develop the severe form of the disease require ventilatory support to maintain adequate gas exchange. The objective of this systematic review was to establish reference parameters of ventilator therapy used in the various levels of severity of adult patients affected by COVID-19 to assist health professionals and hospital managers who will purchase this equipment.MethodsIt used four databases: Medline, Cochrane Central, Scielo, and Pubmed. Restrictions applied as to the language, restricted to English, and to the patient’s profile, only adults affected by SARS-CoV-2. The review process was carried out by three independent reviewers using the PRISMA-P method.ResultsNineteen articles were included, in addition to the recommendations of the Brazilian Association of Intensive Care Medicine (Brazil), Federal Commission for Protection against Health Risks (Mexico), Medicines and Healthcare Products Regulatory Agency (UK), Pan American Health Organization, and World Health Organization. The types of ventilatory therapies found in the articles eligible for this study were continuous positive airway pressure (CPAP), non-invasive ventilation (NIV), and invasive mechanical ventilation (IMV). For each ventilatory therapy, the parameters presented in the article and the recommendations of regulatory agencies and relevant institutions were compared and analyzed.ConclusionIt was possible to suggest a relationship between the respiratory support strategy adopted by the clinical team and the clinical conditions of the patient infected with SARS-CoV-2. The included studies used ventilation modes and parameters within the specifications and recommendations of relevant regulatory agencies and institutions. However, some minor differences were observed in the instruction presented among the agencies more related to the recommended ventilation modes. Further studies are needed.