Uso de máscaras de buceo modificadas para aplicación segura de ventilación no invasiva: Estudio piloto

Rodrigo  Beltramelli; Pedro Alzugaray; Nicolás Rucks; Cristina Santos; Carolina Poradosu; Gimena González; Ana Musetti; Martín Angulo

doi:10.29193/RMU.37.4.1

Authors

Rodrigo Beltramelli Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Tratamiento Intensivo, Laboratorio Exploración Funcional Respiratorio, Asistente
Pedro Alzugaray Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Tratamiento Intensivo, Laboratorio Exploración Funcional Respiratorio, Profesor Agregado
Nicolás Rucks Universidad de la República, Escuela Universitaria Centro de Diseño, Subárea Tecnología. Asistente Área Proyectual, Perfil Producto, Subárea Representación - Modelado 3D Para Prototipado. Ayudante Área Tecnológica
Cristina Santos Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Tratamiento Intensivo, Laboratorio Exploración Funcional Respiratorio, Ex-Profesora Agregada
Carolina Poradosu Universidad de la República, Escuela Universitaria Centro de Diseño/FADU, Directora de la Escuela Universitaria Centro de Diseño, Área Proyectual, Profesora Adjunta
Gimena González Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Laboratorio Exploración Funcional Respiratorio, Licenciada Neumocardióloga
Ana Musetti Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Cátedra de Neumología, Laboratorio Exploración Funcional Respiratorio, Profesora Agregada
Martín Angulo Universidad de la República, Facultad de Medicina, Departamento de Fisiopatología, Profesor Agregado. Hospital de Clínicas, Centro de Tratamiento Intensivo, Laboratorio Exploración Funcional Respiratorio, Profesor Adjunto. Cátedra de Medicina Intensiva, Laboratorio Exploración Funcional Respiratorio

DOI:

https://doi.org/10.29193/RMU.37.4.1

Keywords:

NONINVASIVE VENTILATION, DIVING MASKS, COVID-19

Abstract

Introduction: within the context of the SARS-CoV-2 pandemic, different authors proposed adaptations to snorkeling masks available in the market (modified masks: MM) to provide oxygen therapy with positive pressure ventilation or not. Until today, none of them has assessed its performance as an interface for non-invasive ventilation (NIV) in the inspiratory pressure support mode.
Objective: to develop an interface of NIV using MM and assess its performance with a conventional full mask.
Method: the MM were adapted as NIV interfaces using two pieces created by 3D printing. Their performance was compared to a that of a conventional mask in 10 healthy volunteers in inspiratory pressure support (3 cmH₂O) mode with two levels of positive pressure towards the end of expiration (PEEP 4 and 8 cmH₂O). The following were compared: system leaks, respiratory rate, normal volume, pulse oximetry, transcutaneous carbon dioxide and comfort.
Results: with 4 cmH₂O of PEEP, no significant differences were found between masks in none of the variables studied. With 8 cmH₂O de PEEP, the use of MM were associated to a lower level of CO₂tc (41.0±5.7 vs 43.5±8.1 mmHg; p=0.03) and greater comfort (8.3±1.1 vs 6.5±1.4; p<0.01) than conventional masks (CM).
Conclusions: in healthy volunteers, MM for NIV evidence a similar performance than that of standard oronasal masks, and have a further advantage, as they are more comfortable and cheaper. Even if further studies are needed to support its use, modified snorkeling masks could represent a valid option during the health emergency caused by the SARS-CoV-2 pandemic in consideration of the scarce interfaces available in the market.

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