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Protective face masks add significant dead space
PDPI Lampung & Bengkulu, 26 Sep 2021 11:11:44


Lately, protective face masks have become part of everyday life and many patients and healthcare workers complain of reduced well-being and performance due to the permanent wearing of such masks. Reportedly, the main symptoms are headaches and difficult breathing, especially in combination with stress and physical exertion [1–3]. It is suspected that protective masks impede oxygen supply to the lungs and increase carbon dioxide rebreathing [4]. Theoretical estimations suggest that indeed the dead space increases for mask wearers [5] and this would translate into increased arterial CO2 levels with concomitant increase in work of breathing through control-of-breathing mechanisms. Added flow resistance of protective face masks, as well as comfort and general physiological effects, have been described in the literature [6–8]. However, the effect on gas exchange is poorly investigated, basically because standard procedures involve using a mouthpiece and a nose clip, or a dedicated face mask (European Respiratory Society recommendation [9]), which is obviously not possible in subjects wearing a protective face mask. To investigate this question, the use of a lung simulator seemed to be an obvious approach.

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