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This article is part of the supplement: International Conference on Prevention & Infection Control (ICPIC 2011)

Open Access Poster presentation

Aerosol generating procedures (AGP) and risk of transmission of acute respiratory diseases (ARD): a systematic review

K Tran1, K Cimon1, M Severn1, C Pessoa-Silva2 and J Conly2*

  • * Corresponding author: J Conly

Author Affiliations

1 CADTH, Ottawa, Canada

2 WHO, Geneva, Switzerland

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BMC Proceedings 2011, 5(Suppl 6):P91  doi:10.1186/1753-6561-5-S6-P91


The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1753-6561/5/S6/P91


Published:29 June 2011

© 2011 Tran et al; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction / objectives

The risk of transmission of ARDs to HCWs from AGPs is not fully known. We sought to determine the evidence for the risk of transmission of acute ARDs to HCWs caring for patients undergoing and not undergoing AGPs.

Methods

We searched PubMed, Medline, Embase, Cinahl, the Cochrane Library, Univ of York CRD databases, EuroScan, LILACS, Indian Medlars, Index Medicus for SE Asia,health technology agencies and the Internet in all languages for articles from 01/01/1990 – 22/10/2010. Abstracts and full text articles were screened and included using pre-defined criteria. Disagreements were resolved by consensus and a 3rd reviewer. Data were extracted and verified by a 2nd reviewer. The outcome of interest was risk of ARD transmission. The quality of evidence was rated using the GRADE system.

Results

We identified 5 case-control and 5 retrospective cohort studies which evaluated transmission of SARS to HCWs. Procedures with an ­increased risk of transmission included [n; pooled OR(95%CI)] tracheal intubation [n=8; 6.2 (3.4, 11.3)], non-invasive ventilation [n=2;OR 3.1(1.4, 6.8)], tracheotomy [n=1; 4.2 (1.5, 11.5)] and manual ventilation before intubation [n=1;OR 2.8(1.3, 6.4)]. Other intubation procedures, ET aspiration, suction of body fluids, bronchoscopy, nebulizer treatment, administration of O2, high flow O2, manipulation of O2 mask or BiPAP mask, defibrillation, chest compressions, insertion of NG tube, and collection of sputum were not significant.

Conclusion

Our findings suggest that some procedures have been associated with increased risk of SARS transmission to HCWs with the most consistent association across multiple studies identified with tracheal intubation. These findings must be interpreted in the context of the very low quality of the studies.

Disclosure of interest

K. Tran : None declared, K. Cimon: None declared, M. Severn : None declared, C. Pessoa-Silva: None declared, J. Conly Other Clincal expert for other CADTH projects and speaker honoraria from Industry related to new antimicrobials.