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Systems on Top of Nasal Cannula Improve Oxygen Delivery in Patients with COVID-19: a Randomized Controlled Trial
BACKGROUND: Treating hypoxemia while meeting the soaring demands of oxygen can be a challenge during the COVID-19 pandemic. OBJECTIVE: To determine the efficacy of the surgical facemask and the double-trunk mask on top of the low-flow oxygen nasal cannula on arterial partial pressure of oxygen (PaO(...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971207/ https://www.ncbi.nlm.nih.gov/pubmed/35137298 http://dx.doi.org/10.1007/s11606-022-07419-2 |
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author | Poncin, William Baudet, Lia Braem, Frederic Reychler, Gregory Duprez, Frédéric Liistro, Giuseppe Belkhir, Leila Yombi, Jean Cyr De Greef, Julien |
author_facet | Poncin, William Baudet, Lia Braem, Frederic Reychler, Gregory Duprez, Frédéric Liistro, Giuseppe Belkhir, Leila Yombi, Jean Cyr De Greef, Julien |
author_sort | Poncin, William |
collection | PubMed |
description | BACKGROUND: Treating hypoxemia while meeting the soaring demands of oxygen can be a challenge during the COVID-19 pandemic. OBJECTIVE: To determine the efficacy of the surgical facemask and the double-trunk mask on top of the low-flow oxygen nasal cannula on arterial partial pressure of oxygen (PaO(2)) in hypoxemic COVID-19 patients. DESIGN: Randomized controlled trial. PARTICIPANTS: Hospitalized adults with COVID-19 and hypoxemia treated with the low-flow nasal cannula were enrolled between November 13, 2020, and March 05, 2021. INTERVENTIONS: Patients were randomized in a 1:1:1 ratio to receive either the nasal cannula alone (control) or the nasal cannula covered by the surgical facemask or the double-trunk mask. Arterial blood gases were collected at baseline and 30 min after the use of each system. The oxygen output was adapted afterwards to retrieve the baseline pulse oxygen saturation. The final oxygen output value was recorded after another 30-min period. MAIN MEASURES: The primary outcome was the absolute change in PaO(2). Secondary outcomes included changes in oxygen output, arterial partial pressure of carbon dioxide (PaCO(2)), vital parameters, and breathlessness. KEY RESULTS: Arterial blood samples were successfully collected in 24/27 (8 per group) randomized patients. Compared to the nasal cannula alone, PaO(2) increased with the surgical facemask (mean change: 20 mmHg, 95% CI: 0.7–38.8; P = .04) and with the double-trunk mask (mean change: 40 mmHg; 95% CI: 21–59; P < .001). Oxygen output was reduced when adding the surgical facemask (median reduction: 1.5 L/min [95% CI: 0.5–4.5], P < .001) or the double-trunk mask (median reduction: 3.3 L/min [95% CI: 2–5], P < .001). The double-trunk mask was associated with a PaCO(2) increase of 2.4 mmHg ([95% CI: 0–4.7], P = .049). Neither mask influenced vital parameters or breathlessness. CONCLUSIONS: The addition of the surgical facemask or the double-trunk mask above the nasal cannula improves arterial oxygenation and reduces oxygen consumption. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11606-022-07419-2. |
format | Online Article Text |
id | pubmed-8971207 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-89712072022-05-02 Systems on Top of Nasal Cannula Improve Oxygen Delivery in Patients with COVID-19: a Randomized Controlled Trial Poncin, William Baudet, Lia Braem, Frederic Reychler, Gregory Duprez, Frédéric Liistro, Giuseppe Belkhir, Leila Yombi, Jean Cyr De Greef, Julien J Gen Intern Med Original Research BACKGROUND: Treating hypoxemia while meeting the soaring demands of oxygen can be a challenge during the COVID-19 pandemic. OBJECTIVE: To determine the efficacy of the surgical facemask and the double-trunk mask on top of the low-flow oxygen nasal cannula on arterial partial pressure of oxygen (PaO(2)) in hypoxemic COVID-19 patients. DESIGN: Randomized controlled trial. PARTICIPANTS: Hospitalized adults with COVID-19 and hypoxemia treated with the low-flow nasal cannula were enrolled between November 13, 2020, and March 05, 2021. INTERVENTIONS: Patients were randomized in a 1:1:1 ratio to receive either the nasal cannula alone (control) or the nasal cannula covered by the surgical facemask or the double-trunk mask. Arterial blood gases were collected at baseline and 30 min after the use of each system. The oxygen output was adapted afterwards to retrieve the baseline pulse oxygen saturation. The final oxygen output value was recorded after another 30-min period. MAIN MEASURES: The primary outcome was the absolute change in PaO(2). Secondary outcomes included changes in oxygen output, arterial partial pressure of carbon dioxide (PaCO(2)), vital parameters, and breathlessness. KEY RESULTS: Arterial blood samples were successfully collected in 24/27 (8 per group) randomized patients. Compared to the nasal cannula alone, PaO(2) increased with the surgical facemask (mean change: 20 mmHg, 95% CI: 0.7–38.8; P = .04) and with the double-trunk mask (mean change: 40 mmHg; 95% CI: 21–59; P < .001). Oxygen output was reduced when adding the surgical facemask (median reduction: 1.5 L/min [95% CI: 0.5–4.5], P < .001) or the double-trunk mask (median reduction: 3.3 L/min [95% CI: 2–5], P < .001). The double-trunk mask was associated with a PaCO(2) increase of 2.4 mmHg ([95% CI: 0–4.7], P = .049). Neither mask influenced vital parameters or breathlessness. CONCLUSIONS: The addition of the surgical facemask or the double-trunk mask above the nasal cannula improves arterial oxygenation and reduces oxygen consumption. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11606-022-07419-2. Springer International Publishing 2022-02-08 2022-04 /pmc/articles/PMC8971207/ /pubmed/35137298 http://dx.doi.org/10.1007/s11606-022-07419-2 Text en © The Author(s) under exclusive licence to Society of General Internal Medicine 2022 |
spellingShingle | Original Research Poncin, William Baudet, Lia Braem, Frederic Reychler, Gregory Duprez, Frédéric Liistro, Giuseppe Belkhir, Leila Yombi, Jean Cyr De Greef, Julien Systems on Top of Nasal Cannula Improve Oxygen Delivery in Patients with COVID-19: a Randomized Controlled Trial |
title | Systems on Top of Nasal Cannula Improve Oxygen Delivery in Patients with COVID-19: a Randomized Controlled Trial |
title_full | Systems on Top of Nasal Cannula Improve Oxygen Delivery in Patients with COVID-19: a Randomized Controlled Trial |
title_fullStr | Systems on Top of Nasal Cannula Improve Oxygen Delivery in Patients with COVID-19: a Randomized Controlled Trial |
title_full_unstemmed | Systems on Top of Nasal Cannula Improve Oxygen Delivery in Patients with COVID-19: a Randomized Controlled Trial |
title_short | Systems on Top of Nasal Cannula Improve Oxygen Delivery in Patients with COVID-19: a Randomized Controlled Trial |
title_sort | systems on top of nasal cannula improve oxygen delivery in patients with covid-19: a randomized controlled trial |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971207/ https://www.ncbi.nlm.nih.gov/pubmed/35137298 http://dx.doi.org/10.1007/s11606-022-07419-2 |
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