Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19
Authors: Joseph G. Sorbello
Journal: Annals of Internal Medicine (2020)

Letters17 November 2020Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19FREEJoseph G. Sorbello, MSEd, RT, RRTJoseph G. Sorbello, MSEd, RT, RRTSUNY Upstate Medical University, Syracuse, New York (J.G.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-1178 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I believe that Schünemann and colleagues' living review was well written and provided useful information, but some of the terminology used was not correct. Terminology is important, especially when medical students, residents, and others are reading scientific articles and are in foundational stages of learning. I am certain that you would agree that confusion reigns when correct terminology is not used.The authors referred to “noninvasive ventilation” and included continuous positive airway pressure and high-flow oxygen therapy as ventilation techniques. This is false. Continuous positive airway pressure and high-flow oxygen therapy provide for enhancement of oxygenation, not ventilation. Ventilation, by definition, is movement of air into and out of the lungs. Continuous positive airway pressure and high-flow oxygen therapy techniques do not perform that function; only positive pressure mechanical ventilators do—thus the term noninvasive ventilation. Bilevel positive airway pressure can technically be considered noninvasive ventilation, but many variations of bilevel positive airway pressure do not provide for a mechanical backup rate in case of apnea.In addition, Schünemann and colleagues referred to IMV as “invasive mechanical ventilation.” However, IMV is the acronym for intermittent mandatory ventilation, a particular mode of mechanical ventilation. Saying that IMV represents invasive mechanical ventilation is simply not correct. The plethora of acronyms used in respiratory medicine and respiratory therapy are confusing enough on their own without authors using accepted terms to define something else.Again, Schünemann and colleagues have done a good job but have used terms incorrectly. The Editorial Board should look more closely at terminology to ensure that the reader is reading (and hopefully learning) correct terminology that can then be applied to excellence in patient care.Reference1. Schünemann HJ, Khabsa J, Solo K, et al. Ventilation techniques and risk for transmission of coronavirus disease, including COVID-19. A living systematic review of multiple streams of evidence. Ann Intern Med. 2020;173:204-16. doi:10.7326/M20-2306 LinkGoogle Scholar Comments 0 Comments Sign In to Submit A Comment Author, Article, and Disclosure InformationAuthors: Joseph G. Sorbello, MSEd, RT, RRTAffiliations: SUNY Upstate Medical University, Syracuse, New York (J.G.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-1178. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoVentilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19 Holger J. Schünemann , Joanne Khabsa , Karla Solo , Assem M. Khamis , Romina Brignardello-Petersen , Amena El-Harakeh , Andrea Darzi , Anisa Hajizadeh , Antonio Bognanni , Anna Bak , Ariel Izcovich , Carlos A. Cuello-Garcia , Chen Chen , Ewa Borowiack , Fatimah Chamseddine , Finn Schünemann , Gian Paolo Morgano , Giovanna E.U. Muti-Schünemann , Guang Chen , Hong Zhao , Ignacio Neumann , Jan Brozek , Joel Schmidt , Layal Hneiny , Leila Harrison , Marge Reinap , Mats Junek , Nancy Santesso , Rayane El-Khoury , Rebecca Thomas , Robby Nieuwlaat , Rosa Stalteri , Sally Yaacoub , Tamara Lotfi , Tejan Baldeh , Thomas Piggott , Yuan Zhang , Zahra Saad , Bram Rochwerg , Dan Perri , Eddy Fan , Florian Stehling , Imad Bou Akl , Mark Loeb , Paul Garner , Stephen Aston , Waleed Alhazzani , Wojciech Szczeklik , Derek K. Chu , and Elie A. Akl Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19 Bram Rochwerg , Holger J. Schünemann , and Eli A. Akl Metrics 17 November 2020Volume 173, Issue 10 Page: 860 Keywords Conflicts of interest Continuous positive airway pressure COVID-19 Disclosure Intermittant mandatory ventilation Lungs Noninvasive ventilation Oxygen Patients Ventilators ePublished: 17 November 2020 Issue Published: 17 November 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...