Effects of combined oxygen and surgical masks on inspired fraction of oxygen: relevance to COVID-19-induced respiratory failure

Hamada, Shin; Tanabe, Naoya; Hirai, Toyohiro

doi:10.1016/j.bja.2021.02.025

Cited by 9 publications

(12 citation statements)

References 6 publications

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“…Our observations are in agreement with those of Montiel et al, 1 Hamada et al, 2 and Matsui et al 3 who demonstrated the advantages of a surgical face mask in COVID-19 patients on high-flow nasal cannula for oxygen administration. Though oxygen saturation was satisfactory in all of them, there were interpatient variations in oxygen saturation.…”

Section: Discussionsupporting

confidence: 93%

“…These may be attributable to the position of surgical face mask, entrapment of air, and availability of oxygen beneath the face mask, physiological dead space, and the state of gas exchange. 2 , 3 In addition, the presence of a surgical face mask creates a positive end-expiratory pressure (PEEP) to the lower airways. 2 The increase in the end-expiratory lung volume might have contributed to PEEP effect which were in turn contributed by an elevated resistance in the inward airflow and airway as demonstrated in hydrodynamic model and others.…”

Section: Discussionmentioning

confidence: 99%

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Oxygen Administration under Surgical Face Mask in COVID-19 Patients: A Game Changer

Koushik¹,

Meenakshisundaram²,

Jena³

et al. 2021

Indian Journal of Critical Care Medicine

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COVID-19 is a multifaceted infectious disease. The development of hypoxemic respiratory failure is not uncommon during the course of illness in some of them. The objectives of the present study were to assess the effect of the addition of a surgical face mask while delivering oxygen via nasal cannula in hypoxemic COVID-19 patients and highlight on the advantages and patient's comforts. We prospectively assessed 30 consecutive conscious and hypoxemic COVID-19 patients, requiring oxygen via nasal cannula. The mean PaO 2 without and with surgical face mask were 52 (+9) and 83 (−12) mm Hg respectively in the cohort, and the elevation in oxygen saturation was statistically significant ( p <0.001). The present results encourage the delivery of oxygen under the surgical face mask in symptomatic COVID-19 patients, as it improves oxygen saturation and prevents aerosol dispersion with no change in PaCO 2 . The other advantages of this method are a reduction in the total requirement of oxygen per patient, better utilization of scarce resources, and lessening of the expenses incurred for oxygen. How to cite this article Senthilkumaran S, Koushik M, Meenakshisundaram R, Jena NN, Thirumalaikolundusubramanian P. Oxygen Administration under Surgical Face Mask in COVID-19 Patients: A Game Changer. Indian J Crit Care Med 2021;25(11):1286–1287.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Oxygen Administration under Surgical Face Mask in COVID-19 Patients: A Game Changer

Koushik¹,

Meenakshisundaram²,

Jena³

et al. 2021

Indian Journal of Critical Care Medicine

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“…There have been reports of how oxygenation is affected by the combined use of a surgical mask with an oxygen mask [ 5 , 6 ]. However, the number of subjects included in each report was small, and the results of those reports were inconsistent.…”

Section: Discussionmentioning

confidence: 99%

“…Another reason was that we predicted that if the oxygen flow rate was higher than 4 L/min, the PaO 2 would be higher than 240 mmHg, and some subjects would fall outside the optimal measurement range of ORi [ 9 ]. Although different flow rates of administered oxygen might change the results, there was no significant difference in a similar study when the oxygen flow rate was varied from 5 and 7 to 10 L/min [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…A previous study reported no significant difference in inspiratory oxygen fraction when oxygen was administered over or under the surgical mask [ 5 ]. However, another report showed different results: oxygen administration with the oxygen mask over the surgical mask resulted in lower inhaled oxygen levels than with its administration under the surgical mask [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Investigation of the optimal method of oxygen administration with simultaneous use of a surgical mask: a randomized control study

et al. 2021

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Purpose From the perspective of infection prevention during the Coronavirus disease 2019 (COVID-19) pandemic, a recommendation was made to use surgical masks after extubation in patients in the operating room. For compliance with this recommendation, anesthesiologists need to administer oxygen to the patient with an oxygen mask over the surgical mask. However, no studies have investigated whether this method allows good maintenance of oxygenation in patients. This study aimed to investigate which method of oxygen administration lends itself best to use with a surgical mask in terms of oxygenation. Method We administered oxygen to the study subjects using all the following three methods in random order: an oxygen mask over or under a surgical mask and a nasal cannula under the surgical mask. Oxygenation was assessed using the oxygen reserve index (ORi) and end-tidal oxygen concentration (EtO2). Result This study included 24 healthy volunteers. ORi values with administration of oxygen were higher in the order of a nasal cannula under the surgical mask, an oxygen mask under the surgical mask, and an oxygen mask over the surgical mask, with median values of 0.50, 0.48, and 0.43, respectively, and statistically significant differences between all groups (P < 0.001). EtO2 values were in the same order as ORi, with median values of 33.0%, 31.0%, and 25%, respectively, and statistically significant differences between all groups (P < 0.001). Conclusion Wearing a surgical mask over the nasal cannula during oxygen administration is beneficial for oxygenation and might help prevent aerosol dispersal.

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Effect of Combined Oxygen Therapy and Use of a Surgical Mask or N95 Mask on Inspired Oxygen Fraction and Expired Carbon Dioxide Fraction

Doshu-Kajiura,

Hirose,

Kijima

et al. 2024

Advances in Experimental Medicine and Biology

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Effects of combined oxygen and surgical masks on inspired fraction of oxygen: relevance to COVID-19-induced respiratory failure

Cited by 9 publications

References 6 publications

Oxygen Administration under Surgical Face Mask in COVID-19 Patients: A Game Changer

Oxygen Administration under Surgical Face Mask in COVID-19 Patients: A Game Changer

Investigation of the optimal method of oxygen administration with simultaneous use of a surgical mask: a randomized control study

Effect of Combined Oxygen Therapy and Use of a Surgical Mask or N95 Mask on Inspired Oxygen Fraction and Expired Carbon Dioxide Fraction

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