作者：罂粟花
在氧疗过程中，外科口罩对吸入氧浓度的影响取决于氧气面罩的类型和呼吸条件:基于志愿者和模拟研究
贵州医科大学 麻醉与心脏电生理课题组
翻 译：安丽 编 辑：柏雪 审 校：曹莹
背景:使用外科口罩（SM）可以显著减少咳嗽相关的气溶胶扩散，有助于控制感染。为预防感染，还可能要求接受氧疗的患者佩戴外科口罩。本研究旨在通过在志愿者和模拟实验中，探讨外科面罩在氧疗过程中对吸入氧浓度(FIO2)的影响。
方法：15名志愿者佩戴Hudson RCI®或Open-Face Mask®，佩戴/不佩戴SM。测定氧流量从0 L/min增加到10 L/min的吸入氧浓度(FIO2)、呼气末二氧化碳分压(EtCO2)、吸入二氧化碳分压(PICO2)和呼吸频率(RR)。在这项基于模拟的研究中，呼吸频率分别为12或24次/ min，潮气量(Tv)分别为300、500或700 mL时，使用模拟自主呼吸的模拟器测量FIO2。主要检测指标为6升/分钟时的FIO2。
结果：在这项以志愿者为基础的研究中，当SM与Hudson RCI®或Open-Face Mask®一起使用时，FIO2降低。与Hudson RCI®相比，Open-Face Mask®的FIO2下降更大。RR、EtCO2、PICO2随着SM分别与Hudson RCI®或Open-Face Mask®一起使用时有变化，但差异无临床意义。在模拟研究中，使用Hudson RCI®的SM没有降低FIO2，但使用Open-Face Mask®的SM在某些条件下显著降低了FIO2。然而，当面罩的贴合不合适时，使用Hudson RCI®的SM降低了FIO2。使用Open-Face Mask®时，较低的RR和Tv导致较大的FIO2差异。
结论：使用氧气面罩进行氧疗时，SM降低了吸入氧浓度。SM的影响与吸氧面罩的类型、面罩贴合情况和呼吸情况有关。
原始文献来源：Michiko Kinoshita，Yuki Ishikawa，Ryo Sekiguchi， Miyuki Matsuda， KatsuyaTanaka.Impact of surgical masks on fraction of inspired oxygen during oxygen therapy depends on the type of oxygen masks and respiratory conditions: volunteer‑andsimulation‑based studies.Journal of Anesthesia.Doi.org/10.1007/s00540-022-03083-2.
英文原文：
Impact ofsurgical masks onfraction ofinspired oxygen duringoxygen therapy depends onthetype ofoxygen masks andrespiratory conditions: volunteer‑andsimulation‑based studies
Abstract
Purpose:We investigated the impact of surgical masks (SM) during oxygen therapy using oxygen masks in volunteer- and simulation-based studies.
Methods:Fifteen volunteers wore the Hudson RCI® or Open-Face Mask® with/without an SM. The fraction of inspired oxygen concentration (FIO2), end-tidal CO2 (EtCO2), partial pressure of inspired CO2 (PICO2), and respiratory rate (RR) were measured.The oxygen fow rate increased from 0 to 10 L/min. In the simulation-based study, FIO2 was measured using a simulator that reproduced spontaneous breathing. RR was 12 or 24bpm, and the tidal volume (Tv) was 300, 500, or 700mL. The efect of oxygen mask ftting conditions was also examined. The primary outcome measure was FIO2 at 6 L/min.
Results:In the volunteer-based study, FIO2 was reduced when the SM was used with the Hudson RCI® or Open-Face Mask®. The FIO2 drop was larger with the Open-Face Mask® than with the Hudson RCI®. The RR, EtCO2, and PICO2 signifcantly changed with the SM, but the diferences were not clinically meaningful. In the simulation-based study, the SM with the Hudson RCI® did not reduce FIO2, but the SM with the Open-Face Mask® signifcantly decreased FIO2 under several conditions. However, the SM with the Hudson Mask® reduced FIO2 when the ft of the mask was inadequate. With the Open-Face Mask®, lower RR and Tv resulted in larger diferences in FIO2.
Conclusions:The SM decreased FIO2 during oxygen therapy with oxygen masks. The impact of SM depended on the type of the oxygen mask, mask ftting, and respiratory condition.
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