Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 37
Filter
1.
Biomedicines ; 10(5)2022 May 18.
Article in English | MEDLINE | ID: covidwho-1952991

ABSTRACT

Prolonged daily face mask wearing over several months might affect health of the ocular surface and is reported to be associated with complaints of discomfort and dry-eye-like symptoms. We studied the ocular surface clinical parameters, tear soluble factors and immune cell proportions in ophthalmologists practicing within similar environmental conditions (n = 17) at two time points: pre-face-mask period (Pre-FM; end of 2019) and post-face-mask-wearing period (Post-FM; during 2020 COVID-19 pandemic), with continuous (~8 h/day) mask wear. A significant increase in ocular surface disease index (OSDI) scores without changes in tear breakup time (TBUT), Schirmer's test 1 (ST1) and objective scatter index (OSI) was observed Post-FM. Tear soluble factors (increased-IL-1ß, IL-33, IFNß, NGF, BDNF, LIF and TSLP; decreased-IL-12, IL-13, HGF and VEGF-A) and mucins (MUC5AC) were significantly altered Post-FM. Ex vivo, human donor and corneoscleral explant cultures under elevated CO2 stress revealed that the molecular profile, particularly mucin expression, was similar to the Post-FM tear molecular profile, suggesting hypercapnia is a potential contributor to ocular surface discomfort. Among the immune cell subsets determined from ocular surface wash samples, significantly higher proportions of leukocytes and natural killer T cells were observed in Post-FM compared to Pre-FM. Therefore, it is important to note that the clinical parameters, tear film quality, tear molecular factors and immune cells profile observed in prolonged mask-wear-associated ocular surface discomfort were distinct from dry eye disease or other common ocular surface conditions. These observations are important for differential diagnosis as well as selection of appropriate ocular surface treatment in such subjects.

2.
Biomedicines ; 10(5):1160, 2022.
Article in English | MDPI | ID: covidwho-1857089

ABSTRACT

Prolonged daily face mask wearing over several months might affect health of the ocular surface and is reported to be associated with complaints of discomfort and dry-eye-like symptoms. We studied the ocular surface clinical parameters, tear soluble factors and immune cell proportions in ophthalmologists practicing within similar environmental conditions (n = 17) at two time points: pre-face-mask period (Pre-FM;end of 2019) and post-face-mask-wearing period (Post-FM;during 2020 COVID-19 pandemic), with continuous (~8 h/day) mask wear. A significant increase in ocular surface disease index (OSDI) scores without changes in tear breakup time (TBUT), Schirmer's test 1 (ST1) and objective scatter index (OSI) was observed Post-FM. Tear soluble factors (increased-IL-1β, IL-33, IFNβ, NGF, BDNF, LIF and TSLP;decreased-IL-12, IL-13, HGF and VEGF-A) and mucins (MUC5AC) were significantly altered Post-FM. Ex vivo, human donor and corneoscleral explant cultures under elevated CO2 stress revealed that the molecular profile, particularly mucin expression, was similar to the Post-FM tear molecular profile, suggesting hypercapnia is a potential contributor to ocular surface discomfort. Among the immune cell subsets determined from ocular surface wash samples, significantly higher proportions of leukocytes and natural killer T cells were observed in Post-FM compared to Pre-FM. Therefore, it is important to note that the clinical parameters, tear film quality, tear molecular factors and immune cells profile observed in prolonged mask-wear-associated ocular surface discomfort were distinct from dry eye disease or other common ocular surface conditions. These observations are important for differential diagnosis as well as selection of appropriate ocular surface treatment in such subjects.

3.
Respir Investig ; 60(4): 607-611, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1773723

ABSTRACT

The Japanese government's latest manual on COVID-19 management mentions non-invasive ventilation (NIV). Before this version, we experienced three cases in which COVID-19 was a concern. Each case had one of the following conditions: obesity hypoventilation syndrome, amyotrophic lateral sclerosis, acute heart failure with acute kidney injury with hypercapnia. The guidelines indicate that patients with these diseases are good candidates for NIV. NIV was used in a negative pressure room with staff in personal protective equipment. We describe the use of NIV instruments with anti-viral filters and a non-vented mask, including a new NIV machine for COVID-19 respiratory care.


Subject(s)
COVID-19 , Noninvasive Ventilation , Respiratory Insufficiency , Humans , Masks , Pandemics , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapy , Ventilators, Mechanical
4.
Cultura Ciencia Y Deporte ; 16(49):402-410, 2021.
Article in English | Web of Science | ID: covidwho-1755493

ABSTRACT

The use of the mask in the sports field has been studied to improve the athlete's performance and its protection against a contaminated environment, such as the one existing in the current pandemic panorama of Covid-19. This review analyzes the impact of the mask on different physiological factors while doing physical exercise. A random selection was made of 2,420 studies published in Scholar Google, 118 in SCOPUS and 137 studies published in WOS between the periods 2016-2020, with 95% confidence and +/- 4.3 sampling error, which served for the selection and final analysis of 10 studies chosen intentionally following CTFPHC levels of evidence and the methodological rigor of a structured classification system called PEDro Scale. The results highlight that the use of masks in athletes causes hypoxic and hypercapnic breathing at a certain intensity;the use of masks such as the Elevation Training Mask (ETM) trains the respiratory muscles but does not improve lactic anaerobic performance as intermittent hypoxic training (IHT) does in height. It is discussed about hypoxia and hypercapnia conditions and the use of masks to improve physical performance in athletes.

5.
Journal of Head & Neck Physicians and Surgeons ; 9(2):136-141, 2021.
Article in English | Web of Science | ID: covidwho-1701608

ABSTRACT

Objective: Coronavirus pandemic is a human respiratory disease caused by the severe acute respiratory syndrome (SARS-CoV-2). The objective of the present study was to evaluate the type of mask, frequency of change, difficulties in breathing, dryness of mouth, hazards, and treatment taken for skin allergies if any due to use of facial masks in the present Coronavirus pandemic. Materials and Methods: The present survey was carried on dental practitioners for evaluating knowledge and attitude among 1640 participants. The anonymous survey was carried among different groups of age, gender, and qualifications among dentists all around the globe. SPSS 23.0 statistical software was used for statistical analysis. GraphPad Prism 6 was used for statistical analysis and visualization using Chi-square test, one-way ANOVA and post hoc test. The validity of the questionnaire was pilot tested and measured. The Chron bach's alpha value was 0.71. Results: Among the participants 46.3% used respirators such as N95, filtering facepiece respirators 2, or the equivalent. Surgical masks were used by 43.9% and the remaining used cloth masks. When inter group comparison was done for different age groups, it was found that there was a statistically significant for the type of mask used. Sixty-six percent participants reported oral malodor after using the facial masks while dryness of the mouth was reported in 41.5 and 9.1% reported acne. Conclusion: The use of face masks has become mandatory ornament along with social distancing to avoid transmission. Hypercapnia and breathing difficulties reported were less. For treating the face after long use of facial mask many of the participants reported that no treatment was taken while, others hydrated the face frequently with water, moisturizer and very few used antifungal agent.

6.
Chest ; 161(1):A151, 2022.
Article in English | EMBASE | ID: covidwho-1636378

ABSTRACT

TYPE: TOPIC: Chest Infections PURPOSE: 1.To study interrelation between face-mask and hypercapnia in patients with obstructive airways diseases 2. Occurance of covid-19 in patients of obstructive airways diseases wearing face-mask METHODS: Inclusion criteria: Patients more than 20 years of age Patients known case of obstructive aireays disease on treatment Patients with COPD GOLD B and GOLD C Patients not vaccinated for covid-19 Patients wearing face-mask regularly Exclusion criteria: Patients not consenting for the study Patients with recent history of Myocardial infarction in past 3 months Patients with active tuberculosis and on treatment RESULTS: Our study population was male dominated with 70% males and 30% females Average age group in our study population was 50±6 years (p value<0.01) Average CAT score on initial evaluation was 30±5 (p value<0.01) 5 patients had developed an episode of acute exacerbation of COPD during the time of study and required hospitalisation Average PCO2 levels in hospitalised patients was 70±5mmHg (p value<0.1) There was no significant change noted in CAT score post evaluation after 4-6 weeks with average CAT scores being 30±4 (p value<0.01) There was no change in physical quality of life as measured by DASI index Incidence of covid-19 was approximately 1% with only one study subject developing covid-19 during the study period All subjects enrolled for the study were wearing face mask for at least 6-8 hours/day on an average CONCLUSIONS: Face-mask does not cause hypercapnia in patients with obstructive airwats disease. The incidence of covid-19 was significantly lower in patients of obstructive airways disease wearing face-mask regularly. CLINICAL IMPLICATIONS: Face mask is 100% effective and safe DISCLOSURE: Nothing to declare. KEYWORD: FACE MASK, COPD, COVID19

7.
J Emerg Med ; 62(5): 600-606, 2022 05.
Article in English | MEDLINE | ID: covidwho-1626793

ABSTRACT

BACKGROUND: International COVID-19 guidelines recommend that health care workers (HCWs) wear filtering facepiece (FFP) respirators to reduce exposure risk. However, there are concerns about FFP respirators causing hypercapnia via rebreathing carbon dioxide (CO2). Most previous studies measured the physiological effects of FFP respirators on treadmills or while resting, and such measurements may not reflect the physiological changes of HCWs working in the emergency department (ED). OBJECTIVE: Our aim was to evaluate the physiological and clinical impacts of FFP type II (FFP2) respirators on HCWs during 2 h of their day shift in the ED. METHODS: We included emergency HCWs in this prospective cohort study. We measured end-tidal CO2 (ETCO2), mean arterial pressure (MAP), respiratory rate (RR), and heart rate values and dyspnea scores of subjects at two time points. The first measurements were carried out with medical masks while resting. Subjects then began their day shift in the ED with medical mask plus FFP2 respirator. We called subjects after 2 h for the second measurement. RESULTS: The median age of 153 healthy volunteers was 24.0 years (interquartile range 24.0-25.0 years). Subjects' MAP, RR, and ETCO2 values and dyspnea scores were significantly higher after 2 h. Median ETCO2 values increased from 36.4 to 38.8 mm Hg. None of the subjects had hypercapnia symptoms, hypoxia, or other adverse effects. CONCLUSION: We did not observe any clinical reflection of these changes in physiological values. Thus, we evaluated these changes to be clinically insignificant. We found that it is safe for healthy HCWs to wear medical masks plus FFP2 respirators during a 2-h working shift in the ED.


Subject(s)
COVID-19 , Occupational Exposure , Adult , COVID-19/prevention & control , Carbon Dioxide , Dyspnea/etiology , Dyspnea/prevention & control , Emergency Service, Hospital , Health Personnel , Humans , Hypercapnia , Masks , Occupational Exposure/adverse effects , Occupational Exposure/prevention & control , Prospective Studies , Ventilators, Mechanical , Young Adult
8.
Cultura, Ciencia y Deporte ; 16(49):393-410, 2021.
Article in Spanish | Scopus | ID: covidwho-1609001

ABSTRACT

The use of the mask in the sports field has been studied to improve the athlete’s performance and its protection against a contaminated environment, such as the one existing in the current pandemic panorama of Covid-19. This review analyzes the impact of the mask on different physiological factors while doing physical exercise. A random selection was made of 2,420 studies published in Scholar Google, 118 in SCOPUS and 137 studies published in WOS between the periods 2016-2020, with 95% confidence and +/-4.3 sampling error, which served for the selection and final analysis of 10 studies chosen intentionally following CTFPHC levels of evidence and the methodological rigor of a structured classification system called PEDro Scale. The results highlight that the use of masks in athletes causes hypoxic and hypercapnic breathing at a certain intensity;the use of masks such as the Elevation Training Mask (ETM) trains the respiratory muscles but does not improve lactic anaerobic performance as intermittent hypoxic training (IHT) does in height. It is discussed about hypoxia and hypercapnia conditions and the use of masks to improve physical performance in athletes. © 2021, Universidad Catolica San Antonio Murcia. All rights reserved.

9.
Italian Journal of Medicine ; 15(3):21, 2021.
Article in English | EMBASE | ID: covidwho-1567390

ABSTRACT

Background: Since February 2020, CoViD-19 spread in Italy. Acute respiratory failure (ARF) was the most relevant clinical presentation, often requiring invasive and non-invasive ventilation. We report the management of ARF in in-patients using Easy Vent Mask (EVM) system for C-PAP, a device registered for prehospital use. Methods: In this retrospective study, we included all patients admitted to Emergency Medicine Unit from March 2 to April 25, 2020 with ARF secondary to CoViD-19 pneumonia and treated with EVM system. Our aim was to evaluate the efficacy and tolerability of in-hospital use of EVM system. All demographic, clinical and treatment data were recorded. Results: Thirty patients affected by mild/moderate CoViD-19 pneumonia having PaO2/FiO2(P/F) ratio between 100 and 200 were treated with EVM system for C-PAP, of them 25(83%) were discharged and 5(17%) died in hospital. The system was well tolerated with a mean time of use of 13 consecutive days. Five patients were transferred to ICU due to failure of C-PAP treatment, of whom 3 died. Two patients died in our ward for worsening of clinical conditions. Pressure skin lesions and hypercapnia were recorded as adverse events in 24 and 2 patients respectively. Moreover, our finding showed a higher reduction of P/F value and a longer time from admission to C-PAP initiation in non-survivors, compared to survivor patients. Conclusions: EVM system for C-PAP seemed to be well tolerated and may represent an alternative to ventilators in in-hospital treatment of CoViD-19 mild/moderate pneumonia, but dedicated studies are needed.

10.
CHEST ; 160(4):A1404-A1404, 2021.
Article in English | Academic Search Complete | ID: covidwho-1460867
11.
Messenger of Anesthesiology and Resuscitation ; 18(3):15-22, 2021.
Article in Russian | Scopus | ID: covidwho-1342084

ABSTRACT

The objective: in patients with COVID-19, to study the relationship of transcutaneous saturation values with clinical indicators that characterize ARF, the state of acid-base balance and blood gas composition. Subjects and methods. A multicenter prospective observational study included 90 COVID-19 patients treated in ICU whose transcutaneous saturation (SpO2) values were below 93% despite treatment. Depending on the degree of impaired oxygenation, patients underwent oxygen therapy through a mask or nasal cannula, high-flow oxygenation or non-invasive ventilation, while it was not always possible to achieve the target values of oxygenation parameters. The patients were divided into the following groups: Group 1 - SpO2 above 93%, Group 2 - SpO2 within 93-90%, Group 3 - SpO2 within 85-89%, Group 4- SpO2 within 80-84%, Group 5 - SpO2 within 75-79%, and Group 6 - below 75%. Results. It was revealed that during ARF management by noninvasive methods, different values of transcutaneous saturation and corresponding changes in the acid-base balance (ABB) and blood gas composition were determined When transcutaneous saturation (SpO2) decreased to 85%, there was a corresponding moderate decrease in PaO2 while no metabolic changes occurred. As a rule, there were no obvious clinical signs of respiratory failure (silent hypoxia). In patients with SpO2 reduction down 80-85%, clinical signs of respiratory failure (dyspnea, tachypnea, agitation) and, as a rule, a moderate increase in PаCO2 with the development of respiratory acidosis and compensatory metabolic alkalosis were noted. When SpO2 decreased down to 75-79%, arterial hypoxemia was usually accompanied by moderate hypercapnia and the development of decompensated mixed acidosis and venous desaturation as well as increased lactate levels. With transcutaneous saturation going below 74%, these changes were even more pronounced and were observed in all patients of this group. Conclusion. The revealed changes are mostly consistent with generally accepted ideas about the relationship between values of transcutaneous saturation and blood gas composition and parameters of blood ABB in the case of ARF. Reduction of transcutaneous saturation down to 85% not accompanied by pronounced clinical signs of respiratory failure (dyspnea, tachypnea, agitation), development of acidosis and venous desaturation, and the elevated lactate level can be regarded as relatively safe. © 2021 Serbian Chemical Society. All rights reserved.

12.
Chest ; 160(6): 2135-2145, 2021 12.
Article in English | MEDLINE | ID: covidwho-1340589

ABSTRACT

The prevalence of obesity is rising worldwide. Adipose tissue exerts anatomic and physiological effects with significant implications for critical illness. Changes in respiratory mechanics cause expiratory flow limitation, atelectasis, and V̇/Q̇ mismatch with resultant hypoxemia. Altered work of breathing and obesity hypoventilation syndrome may cause hypercapnia. Challenging mask ventilation and peri-intubation hypoxemia may complicate intubation. Patients with obesity are at increased risk of ARDS and should receive lung-protective ventilation based on predicted body weight. Increased positive end expiratory pressure (PEEP), coupled with appropriate patient positioning, may overcome the alveolar decruitment and intrinsic PEEP caused by elevated baseline pleural pressure; however, evidence is insufficient regarding the impact of high PEEP strategies on outcomes. Venovenous extracorporeal membrane oxygenation may be safely performed in patients with obesity. Fluid management should account for increased prevalence of chronic heart and kidney disease, expanded blood volume, and elevated acute kidney injury risk. Medication pharmacodynamics and pharmacokinetics may be altered by hydrophobic drug distribution to adipose depots and comorbid liver or kidney disease. Obesity is associated with increased risk of VTE and infection; appropriate dosing of prophylactic anticoagulation and early removal of indwelling catheters may decrease these risks. Obesity is associated with improved critical illness survival in some studies. It is unclear whether this reflects a protective effect or limitations inherent to observational research. Obesity is associated with increased risk of intubation and death in SARS-CoV-2 infection. Ongoing molecular studies of adipose tissue may deepen our understanding of how obesity impacts critical illness pathophysiology.


Subject(s)
COVID-19/mortality , Obesity/complications , Obesity/physiopathology , COVID-19/complications , COVID-19/therapy , Critical Illness , Humans , Respiration, Artificial
13.
Respir Physiol Neurobiol ; 294: 103765, 2021 12.
Article in English | MEDLINE | ID: covidwho-1336881

ABSTRACT

INTRODUCTION: Concerns have been raised that COVID-19 face coverings compromise lung function and pulmonary gas exchange to the extent that they produce arterial hypoxemia and hypercapnia during high intensity exercise resulting in exercise intolerance in recreational exercisers. This study therefore aimed to investigate the effects of a surgical, flannel or vertical-fold N95 masks on cardiorespiratory responses to incremental exercise. METHODS: This investigation studied 11 adult males and females at rest and while performing progressive cycle exercise to exhaustion. We tested the hypotheses that wearing a surgical (S), flannel (F) or horizontal-fold N95 mask compared to no mask (control) would not promote arterial deoxygenation or exercise intolerance nor alter primary cardiovascular variables during submaximal or maximal exercise. RESULTS: Despite the masks significantly increasing end-expired peri-oral %CO2 and reducing %O2, each ∼0.8-2% during exercise (P < 0.05), our results supported the hypotheses. Specifically, none of these masks reduced sub-maximal or maximal exercise arterial O2 saturation (P = 0.744), but ratings of dyspnea were significantly increased (P = 0.007). Moreover, maximal exercise capacity was not compromised nor were there any significant alterations of primary cardiovascular responses (mean arterial pressure, stroke volume, cardiac output) found during sub-maximal exercise. CONCLUSION: Whereas these results are for young healthy recreational male and female exercisers and cannot be applied directly to elite athletes, older or patient populations, they do support that arterial hypoxemia and exercise intolerance are not the obligatory consequences of COVID-19-indicated mask-wearing at least for cycling exercise.


Subject(s)
COVID-19/prevention & control , Exercise Tolerance/physiology , Masks/adverse effects , Oxygen/blood , Adult , Female , Humans , Male , SARS-CoV-2
14.
BMJ Open ; 11(7): e046364, 2021 07 08.
Article in English | MEDLINE | ID: covidwho-1304228

ABSTRACT

OBJECTIVE: Countries have major differences in the acceptance of face mask use for the prevention of COVID-19. This work aims at studying the information online in different countries in terms of information quality and content. DESIGN: Content analysis. METHOD: We analysed 450 webpages returned by searching the string 'are face masks dangerous' in Italy, the UK and the USA using three search engines (Bing, Duckduckgo and Google) in August 2020. The type of website and the stance about masks were assessed by two raters for each language and inter-rater agreement reported as Cohen's kappa. The text of the webpages was collected from the web using WebBootCaT and analysed using a corpus analysis software to identify issues mentioned. RESULTS: Most pages were news outlets, and few (2%-6%) from public health agencies. Webpages with a negative stance on masks were more frequent in Italian (28%) than English (19%). Google returned the highest number of mask-positive pages and Duckduckgo the lowest. Google also returned the lowest number of pages mentioning conspiracy theories and Duckduckgo the highest. Webpages in Italian scored lower than those in English in transparency (reporting authors, their credentials and backing the information with references). When issues about the use of face masks were analysed, mask effectiveness was the most discussed followed by hypercapnia (accumulation of carbon dioxide), contraindication in respiratory disease and hypoxia, with issues related to their contraindications in mental health conditions and disability mentioned by very few pages. CONCLUSIONS: This study suggests that: (1) public health agencies should increase their web presence in providing correct information on face masks; (2) search engines should improve the information quality criteria in their ranking; (3) the public should be more informed on issues related to the use of masks and disabilities, mental health and stigma arising for those people who cannot wear masks.


Subject(s)
COVID-19 , Search Engine , Humans , Internet , Italy , Language , Masks , SARS-CoV-2
16.
Photodiagnosis Photodyn Ther ; 34: 102279, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1246137

ABSTRACT

PURPOSE: We aimed to show the changes in choroidal thickness (CT) with spectral domain optical coherence tomography (SD-OCT) after prolonged use of N95 mask. METHOD: The healthcare workers who use the N95 face-mask, between 30-50 years of age who have best corrected visual acuity (BCVA) ≥10/10, spherical or cylindrical refraction errors less than 2 diopters, with normal intra ocular pressure (IOP), axial length (AL) between 22-24 mm included in the study. The choroid was imaged with enhanced depth imaging (EDI) techniques using SD-OCT. CT was measured, subfoveal, at 1000 µm nasal and temporal of the center of the fovea. Measurements were first made after wearing the N95 mask for at least 2 h without removing it and repeated 15 min after removing. RESULTS: After 2 h of the N95 mask using without removal, the mean subfoveal CT was 293.56 ± 76.12(min:185, max:479), the mean temporal CT was 253.81 ± 63.48(min:172, max:384), the mean nasal CT was 239.18 ± 53.92(min:139, max:356). Fifteen minutes after removal of the N95 mask, the mean subfoveal CT was 250.56 ± 52.48(min:172, max:397), the mean temporal was 218.40 ± 53.58(min:129, max:354), the mean nasal CT was 210.67 ± 53.31(min:132, max:366). The differences in subfoveal, temporal and nasal CT between 2 h of N95 mask use and 15 min after removal of the mask were statistically significant (p < 0.05 for each). CONCLUSION: Hypercapnia due to prolonged use of the N95 mask may cause choroidal hemodynamic changes and transient increased choroidal thickness.


Subject(s)
N95 Respirators , Photochemotherapy , Choroid/diagnostic imaging , Delivery of Health Care , Health Personnel , Humans , Photochemotherapy/methods , Photosensitizing Agents , Tomography, Optical Coherence
17.
Neuropsychiatr Dis Treat ; 17: 1563-1569, 2021.
Article in English | MEDLINE | ID: covidwho-1244940

ABSTRACT

PURPOSE: Airway management is a key objective in adapted electroconvulsive therapy (ECT) protocols during the COVID-19 pandemic to prevent infection. The objective of this study was to describe the effectiveness of a modified ventilation procedure designed to reduce aerosol-generating bag-mask ventilation (BMV) and isolate possible droplets while maintaining adequate respiratory gas values in ECT sessions. MATERIALS AND METHODS: This prospective study analyzed the results of the modified protocol applied over a month. Adaptations entailed preoxygenation and extension of the voluntary hyperventilation (VHV) time for two minutes before anesthesia induction, asking patients to hyperventilate with oxygen therapy via nasal cannula and while wearing a face mask. Thereafter, vigorous hyperventilation was avoided, and patients were only assisted with tightly sealed BMV until emergence from anesthesia, isolating the ventilation by using a single-use plastic device. Oxygen saturation (SpO2) and transcutaneous partial pressure of carbon dioxide (TcPCO2) were recorded throughout the session. RESULTS: The study included 74 sessions of bilateral ECT with the modified ventilation protocol in 15 subjects. After VHV, the mean SpO2 increase was 2.12±2.14%, and the mean TcPCO2 decrease was 4.05±2.98 mmHg. TcPCO2 values at the moment of stimulus administration were 2.22±3.07 mmHg below pre-ECT values. The mean EEG seizure was 38.70±17.03 s, and postictal suppression was 68.31± 34.58% and 2.13±0.75 on a 0-3 scale. Brief desaturation (SpO2 <90) of 4-5 seconds duration was observed in 4 sessions. CONCLUSION: This modified ventilation protocol was effective during COVID-19, and it did not elicit significant side effects. In addition to avoiding vigorous BMV, it induced moderate hypocapnia, which has been tied to seizure optimization and less hypercapnia during the apnea period.

18.
Med Hypotheses ; 146: 110411, 2021 01.
Article in English | MEDLINE | ID: covidwho-1225344

ABSTRACT

Many countries across the globe utilized medical and non-medical facemasks as non-pharmaceutical intervention for reducing the transmission and infectivity of coronavirus disease-2019 (COVID-19). Although, scientific evidence supporting facemasks' efficacy is lacking, adverse physiological, psychological and health effects are established. Is has been hypothesized that facemasks have compromised safety and efficacy profile and should be avoided from use. The current article comprehensively summarizes scientific evidences with respect to wearing facemasks in the COVID-19 era, providing prosper information for public health and decisions making.


Subject(s)
COVID-19/prevention & control , Masks , Models, Biological , Pandemics/prevention & control , SARS-CoV-2 , COVID-19/transmission , COVID-19/virology , Humans , Hypercapnia/etiology , Hypercapnia/physiopathology , Hypercapnia/psychology , Hypoxia/etiology , Hypoxia/physiopathology , Hypoxia/psychology , Masks/adverse effects , Masks/standards , Masks/virology , N95 Respirators/adverse effects , N95 Respirators/standards , N95 Respirators/virology , Respiration , Safety , Treatment Outcome
19.
BMC Infect Dis ; 21(1): 354, 2021 Apr 16.
Article in English | MEDLINE | ID: covidwho-1190059

ABSTRACT

BACKGROUND AND PURPOSE: COVID-19 pandemic led to wide-spread use of face-masks, respirators and other personal protective equipment (PPE) by healthcare workers. Various symptoms attributed to the use of PPE are believed to be, at least in part, due to elevated carbon-dioxide (CO2) levels. We evaluated concentrations of CO2 under various PPE. METHODS: In a prospective observational study on healthy volunteers, CO2 levels were measured during regular breathing while donning 1) no mask, 2) JustAir® powered air purifying respirator (PAPR), 3) KN95 respirator, and 4) valved-respirator. Serial CO2 measurements were taken with a nasal canula at a frequency of 1-Hz for 15-min for each PPE configuration to evaluate whether National Institute for Occupational Safety and Health (NIOSH) limits were breached. RESULTS: The study included 11 healthy volunteers, median age 32 years (range 16-54) and 6 (55%) men. Percent mean (SD) changes in CO2 values for no mask, JustAir® PAPR, KN95 respirator and valve respirator were 0.26 (0.12), 0.59 (0.097), 2.6 (0.14) and 2.4 (0.59), respectively. Use of face masks (KN95 and valved-respirator) resulted in significant increases in CO2 concentrations, which exceeded the 8-h NIOSH exposure threshold limit value-weighted average (TLV-TWA). However, the increases in CO2 concentrations did not breach short-term (15-min) limits. Importantly, these levels were considerably lower than the long-term (8-h) NIOSH limits during donning JustAir® PAPR. There was a statistically significant difference between all pairs (p < 0.0001, except KN95 and valved-respirator (p = 0.25). However, whether increase in CO2 levels are clinically significant remains debatable. CONCLUSION: Although, significant increase in CO2 concentrations are noted with routinely used face-masks, the levels still remain within the NIOSH limits for short-term use. Therefore, there should not be a concern in their regular day-to-day use for healthcare providers. The clinical implications of elevated CO2 levels with long-term use of face masks needs further studies. Use of PAPR prevents relative hypercapnoea. However, whether PAPR should be advocated for healthcare workers requiring PPE for extended hours needs to evaluated in further studies.


Subject(s)
COVID-19/prevention & control , Carbon Dioxide/analysis , Masks , Respiratory Protective Devices , Adolescent , Adult , Female , Health Personnel , Humans , Hypercapnia/etiology , Male , Middle Aged , Prospective Studies , Time Factors , Young Adult
20.
Neuroimage ; 229: 117752, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1030645

ABSTRACT

International spread of the coronavirus SARS-CoV-2 has prompted many MRI scanning facilities to require scan subjects to wear a facial covering ("mask") during scanning as a precaution against transmission of the virus. Because wearing a mask mixes expired air with the subject's inspired air stream, the concentration of inspired carbon dioxide [CO2] is elevated, resulting in mild hypercapnia. Changes in the inspired gas mixture have been demonstrated to alter R2*-weighted Blood Oxygen Dependent (BOLD) contrast. In this study, we investigate a potential for face masking to alter BOLD contrast during a sensory-motor task designed to activate visual, auditory, and sensorimotor cortices in 8 subjects. We utilize a nasal cannula to supply air to the subject wearing a surgical mask in on-off blocks of 90s to displace expired CO2, while the subject performs the sensory-motor task. While only a small fraction (2.5%) of the sensory-motor task activation is related to nasal air modulation, a 30.0% change in gray matter BOLD signal baseline is found due to air modulation. Repeating the scan with mask removed produces a small subject-specific bias in BOLD baseline signal from nasal air supply, which may be due to cognitive influence of airflow or cannula-induced hypoxia. Measurements with capnography demonstrate wearing a mask induces an average increase in ETCO2 of 7.4%. Altogether, these results demonstrate that wearing a face mask during gradient-echo fMRI can alter BOLD baseline signal but minimally affects task activation.


Subject(s)
Carbon Dioxide/metabolism , Functional Neuroimaging , Gray Matter/physiology , Magnetic Resonance Imaging , Masks , Psychomotor Performance/physiology , Sensorimotor Cortex/physiology , Adult , COVID-19/prevention & control , Gray Matter/diagnostic imaging , Gray Matter/metabolism , Humans , Sensorimotor Cortex/diagnostic imaging , Sensorimotor Cortex/metabolism , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL