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[面罩吸氧时佩戴口罩对自主呼吸受试者氧合的影响]

[Effects of wearing a mask on oxygenation of subjects with spontaneous breathing during supplementary oxygen through facemask].

作者信息

Zhao Na, Jing Yumiao, Guan Jufen, Li Xiang, Li Xiaoguang, Xing Yunfei, Xiang Xinghua, Hou YongLi, Huang Xuejiao, Zhang Xiyue, He Jinxin, Wang Xuejuan, Xu Mingjun

机构信息

Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, P.R.China.

Department of Anesthesiology, Beijing Huairou Maternal and Child Health Care Hospital, Capital Medical University, Beijing 100191, P.R.China.

出版信息

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2020 Dec 25;37(6):1025-1030. doi: 10.7507/1001-5515.202007017.

Abstract

During the COVID-19 epidemic, our national guidelines have suggested that surgical patients should wear a mask to decrease the potential transmission of COVID-19 in the operating room, as long as the condition allows. However, so far, there is no study to discuss the influence of wearing a mask on the ventilation and blood oxygenation status in patients of spontaneous breathing with supplementary oxygen through an anesthetic facemask. This is a before-after study in the same patient, and 10 healthy volunteers were recruited, by testing the arterial blood gas parameters at key time points before and after oxygen inhalation to evaluate the effects of two different supplementary oxygen methods ('disposable medical mask + anesthetic facemask' and 'anesthetic facemask only') on the oxygenation of subjects. Our data demonstrated whether wearing a disposable medical mask or not could effectively increase the oxygen supply of the subjects compared with the basic value before oxygen inhalation; however, compared with the group without mask, the arterial oxygen partial (PaO ) reduced significantly at each time points when subjects wearing a disposable medical mask. There was no significant difference in other parameters, and our data showed that age growth and smoking had no significant effects on the difference of PaO between the groups with and without masks. This study demonstrates effective oxygen supplementation through anesthetic facemask in subjects with spontaneous breathing who is wearing a disposable medical mask, whose pulse oxygen saturation and arterial oxygen saturation can reach 100% rapidly, and this provides a theoretical basis for the management of patients with disseminated respiratory diseases to wear masks in the operating room; however, the rate and amount of PaO increase are both decreased as compared to those who is not wearing a disposable medical mask during supplementary oxygenation. Whether this difference will affect the clinical outcome needs further study.

摘要

在新冠疫情期间,我国指南建议,只要条件允许,手术患者应佩戴口罩以降低手术室中新冠病毒的潜在传播风险。然而,到目前为止,尚无研究探讨佩戴口罩对通过麻醉面罩吸氧的自主呼吸患者通气和血氧状态的影响。这是一项针对同一患者的前后对照研究,招募了10名健康志愿者,通过检测吸氧前后关键时间点的动脉血气参数,评估两种不同吸氧方法(“一次性医用口罩+麻醉面罩”和“仅使用麻醉面罩”)对受试者氧合的影响。我们的数据表明,与吸氧前的基础值相比,无论是否佩戴一次性医用口罩都能有效增加受试者的氧气供应;然而,与不戴口罩组相比,佩戴一次性医用口罩的受试者在各时间点的动脉血氧分压(PaO)均显著降低。其他参数无显著差异,且我们的数据表明年龄增长和吸烟对戴口罩组与不戴口罩组之间的PaO差异无显著影响。本研究表明,对于佩戴一次性医用口罩的自主呼吸受试者,通过麻醉面罩可有效补充氧气,其脉搏血氧饱和度和动脉血氧饱和度可迅速达到100%,这为手术室中患有播散性呼吸道疾病的患者佩戴口罩管理提供了理论依据;然而,与吸氧时不佩戴一次性医用口罩的受试者相比,PaO升高的速率和幅度均降低。这种差异是否会影响临床结局尚需进一步研究。

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本文引用的文献

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Clinical Characteristics of Coronavirus Disease 2019 in China.《中国 2019 年冠状病毒病临床特征》
N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056/NEJMoa2002032. Epub 2020 Feb 28.
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Cochrane Database Syst Rev. 2016 Mar 16;3(3):CD006161. doi: 10.1002/14651858.CD006161.pub3.

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