Bacterial-viral filters to limit the spread of aerosolized respiratory pathogens during neonatal respiratory support in a pandemic era

The novel coronavirus disease 2019 has raised several questions about how to limit the spread of highly transmissible respiratory viruses. While guidelines and recommendations exist for adult patients, these cannot be extrapolated to infants and neonates, as neonatal respiratory support presents specific issues (e.g., high apparatus dead space compared to neonatal airways, high bias flows, humidified gases, etc.) that make the transmission of respiratory pathogen control particularly challenging. Three recent papers address the issues of pathogen transmission, aerosol-generating procedures, and infection control before, during, and after neonatal resuscitation and during different respiratory support modes in the neonatal intensive care unit. This document provides more detailed indications on how to use bacterial–viral filters to reduce the spread of respiratory pathogens from neonatal patients with acute respiratory infections receiving respiratory support, with a focus on the protection of the environment and healthcare workers.