Nierat Marie-Cécile, Raux M, Redolfi S, Gonzalez-Bermejo J, Biondi G, Straus C, Rivals I, Morélot-Panzini C, Similowski T
Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.
Département d'Anesthésie-Réanimation, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France.
J R Army Med Corps. 2019 Oct;165(5):317-324. doi: 10.1136/jramc-2018-001028. Epub 2018 Nov 9.
Preventing in-flight hypoxia in pilots is typically achieved by wearing oxygen masks. These masks must be as comfortable as possible to allow prolonged and repeated use. The consequences of mask-induced facial contact pressure have been extensively studied, but little is known about mask-induced breathing discomfort. Because breathlessness is a strong distractor and engages cerebral resources, it could negatively impact flying performances.
Seventeen volunteers (age 20-32) rated respiratory discomfort while breathing with no mask and with two models of quick-donning full-face crew oxygen masks with regulators (mask A, mask B). Electroencephalographic recordings were performed to detect a putative respiratory-related cortical activation in response to inspiratory constraint (experiment 1, n=10). Oxygen consumption was measured using indirect calorimetry (experiment 2, n=10).
With mask B, mild respiratory discomfort was reported significantly more frequently than with no mask or mask A (experiment 1: median respiratory discomfort on visual analogue scale 0.9 cm (0.5-1.4), experiment 1; experiment 2: 2 cm (1.7-2.9)). Respiratory-related cortical activation was present in 1/10 subjects with no mask, 1/10 with mask A and 6/10 with mask B (significantly more frequently with mask B). Breathing pattern, sigh frequency and oxygen consumption were not different.
In a laboratory setting, breathing through high-end aeronautical full-face crew oxygen masks can induce mild breathing discomfort and activate respiratory-related cortical networks. Whether or not this can occur in real-life conditions and have operational consequences remains to be investigated. Meanwhile, respiratory psychometric and neuroergonomic approaches could be worth integrating to masks development and evaluation processes.
预防飞行员飞行过程中的缺氧通常是通过佩戴氧气面罩来实现的。这些面罩必须尽可能舒适，以便能够长时间反复使用。面罩引起的面部接触压力的后果已得到广泛研究，但对面罩引起的呼吸不适却知之甚少。由于呼吸急促是一种强烈的干扰因素，会占用大脑资源，因此可能会对飞行表现产生负面影响。
17名志愿者（年龄20 - 32岁）在不戴面罩以及佩戴两种带调节器的快速佩戴式全脸机组人员氧气面罩（面罩A、面罩B）呼吸时对呼吸不适进行评分。进行脑电图记录以检测对吸气限制做出反应的假定呼吸相关皮质激活（实验1，n = 10）。使用间接量热法测量耗氧量（实验2，n = 10）。
使用面罩B时，报告有轻度呼吸不适的频率明显高于不戴面罩或使用面罩A时（实验1：视觉模拟量表上的呼吸不适中位数为0.9厘米（0.5 - 1.4），实验1；实验2：2厘米（1.7 - 2.9））。不戴面罩的受试者中有1/10、戴面罩A的受试者中有1/10以及戴面罩B的受试者中有6/10出现呼吸相关皮质激活（面罩B出现的频率明显更高）。呼吸模式、叹气频率和耗氧量没有差异。
在实验室环境中，通过高端航空全脸机组人员氧气面罩呼吸会引起轻度呼吸不适并激活呼吸相关皮质网络。这在现实生活条件下是否会发生以及是否会产生操作后果仍有待研究。同时，呼吸心理测量和神经工效学方法可能值得纳入面罩开发和评估过程。
