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研究每天佩戴N95口罩和个人防护装备套件6小时的医护人员脑部氧合在MRI上的急性变化。

To Study Acute Changes in Brain Oxygenation on MRI in Healthcare Workers Using N95 Mask and PPE Kits for Six Hours a Day.

作者信息

Vakharia Rahul Jitendra, Jani Ishaan, Yadav Shashibala, Kurian Thomas

机构信息

Department of Radiodiagnosis, Wockhardt Hospital, Mumbai, Maharashtra, India.

MRI Applications, Philips India Limited, Mumbai, Maharashtra, India.

出版信息

Indian J Radiol Imaging. 2022 Jan 10;31(4):893-900. doi: 10.1055/s-0041-1741086. eCollection 2021 Oct.

Abstract

Due to long working hours wearing an N95 mask and PPE kit during the COVID-19 pandemic, the healthcare workers (HCWs) complained of headaches, confusion, and exhaustion. This study was therefore performed to study the changes in brain oxygenation.  To compare brain oxygenation in health care workers wearing an N95 mask with a PPE kit versus a three-ply mask during an intensive care setting for 6 hours.  Thirty clinicians and 30 paramedical staff participated in the study. The control (three-ply mask) and subject (N95 mask with PPE) groups included 15 clinicians and 15 paramedical staff. A comparative analysis of brain oxygenation using a 3T magnetic resonance imaging (MRI) machine was performed in these two groups at the beginning and the end of their work shift.  The mean age of the individuals in the control and subject groups was 30.8 and 30.13 years, respectively. The median value of brain oxygenation in the control and subject groups in the pre-shift was between 33 and 31 and post-shift was 30 and 24. The drop in brain oxygenation in subjects was more than the controls (  = 0.004) in the post-shift assessments. The cerebral blood flow (CBF) in the bilateral middle cerebral artery (MCA) using arterial spin labeling (ASL) showed a rise in CBF in both groups post-shift as compared with the pre-shift values. The median values of the right and left MCA in the control and subject groups pre-shift were 82.75/83.45 and 89.75/106.65. The post-shift median values of both MCAs of the control and subject groups were 115.65/115.55 and 109.60/119.49.  MRI-BOLD imaging revealed a significant drop in brain oxygenation in the subject group as compared with the control group. Multiphasic-ASL showed a compensatory rise in CBF in both groups.

摘要

在新冠疫情期间,由于长时间佩戴N95口罩和个人防护装备套装,医护人员出现了头痛、意识模糊和疲惫等症状。因此,开展了本研究以探究脑氧合的变化情况。

为比较在重症监护环境下佩戴N95口罩和个人防护装备套装的医护人员与佩戴三层口罩的医护人员在6小时内的脑氧合情况。

30名临床医生和30名医护辅助人员参与了本研究。对照组(三层口罩)和实验组(N95口罩与个人防护装备套装)各包括15名临床医生和15名医护辅助人员。在这两组人员轮班开始和结束时,使用3T磁共振成像(MRI)机器对脑氧合进行了对比分析。

对照组和实验组人员的平均年龄分别为30.8岁和30.13岁。轮班前,对照组和实验组脑氧合的中位数分别在33至31之间,轮班后分别为30和24。在轮班后评估中,实验组脑氧合的下降幅度大于对照组(P = 0.004)。使用动脉自旋标记(ASL)技术测量双侧大脑中动脉(MCA)的脑血流量(CBF)结果显示,与轮班前相比,两组人员轮班后脑血流量均有所增加。对照组和实验组轮班前右侧和左侧MCA的中位数分别为82.75/83.45和89.75/106.65。对照组和实验组轮班后双侧MCA的中位数分别为115.65/115.55和109.60/119.49。

MRI血氧水平依赖性功能磁共振成像(MRI-BOLD)显示,与对照组相比,实验组的脑氧合显著下降。多相ASL显示两组的脑血流量均出现代偿性增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50bd/8817801/ef2c234a4bd9/10-1055-s-0041-1741086-i2120102-1.jpg

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