RT Journal Article
SR Electronic
T1 “You can leave your mask on”: effects on cardiopulmonary parameters of different airway protection masks at rest and during maximal exercise
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2004473
DO 10.1183/13993003.04473-2020
A1 Mapelli, Massimo
A1 Salvioni, Elisabetta
A1 De Martino, Fabiana
A1 Mattavelli, Irene
A1 Gugliandolo, Paola
A1 Vignati, Carlo
A1 Farina, Stefania
A1 Palermo, Pietro
A1 Campodonico, Jeness
A1 Maragna, Riccardo
A1 Lo Russo, Gerardo
A1 Bonomi, Alice
A1 Sciomer, Susanna
A1 Agostoni, Piergiuseppe
YR 2021
UL http://erj.ersjournals.com/content/early/2021/02/04/13993003.04473-2020.abstract
AB Background During the COVID-19 pandemic, the use of protection masks is essential to reduce contagions. However, public opinion reports an associated subjective shortness of breath. We evaluated cardiorespiratory parameters at rest and during maximal exertion to highlight any differences with the use of protection masks.Methods Twelve healthy subjects underwent three cardiopulmonary exercise tests: without wearing protection mask, with surgical and with FFP2 mask. Dyspnea was assessed by Borg Scale. Standard pulmonary function tests were also performed.Results All the subjects (40.8±12.4 years; 6 males) completed the protocol with no adverse event. At spirometry, from no mask to surgical to FFP2, a progressive reduction of FEV1 and FVC was observed (3.94±0.91 l, 3.23±0.81 l, 2.94±0.98 l and 4.70±1.21 l, 3.77±1.02 l, 3.52±1.21 l, respectively, p<0.001). Rest ventilation, O2 uptake (V̇O2) and CO2 production (VCO2) were progressively lower with a reduction of respiratory rate. At peak exercise, subjects revealed a progressively higher Borg scale when wearing surgical and FFP2. Accordingly, at peak exercise, V̇O2 (31.0±23.4, 27.5±6.9, 28.2±8.8 ml/kg/min, p=0.001), ventilation (92±26, 76±22, 72±21 l, p=0.003), respiratory rate (42±8, 38±5, 37±4, p=0.04) and tidal volume (2.28±0.72, 2.05±0.60, 1.96±0.65 l, p=0.001) were gradually lower. We did not observed a significant difference in oxygen saturation.Conclusions Protection masks are associated with significant but modest worsening of spirometry and cardiorespiratory parameters at rest and peak exercise. The effect is driven by a ventilation reduction due to an increased airflow resistance. However, since exercise ventilatory limitation is far from being reached, their use is safe even during maximal exercise, with a slight reduction in performance.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Mapelli has nothing to disclose.Conflict of interest: Dr. Salvioni has nothing to disclose.Conflict of interest: Dr. De Martino has nothing to disclose.Conflict of interest: Dr. Mattavelli has nothing to disclose.Conflict of interest: Dr. Gugliandolo has nothing to disclose.Conflict of interest: Dr. Vignati has nothing to disclose.Conflict of interest: Dr. Farina has nothing to disclose.Conflict of interest: Dr. Palermo has nothing to disclose.Conflict of interest: Dr. Campodonico has nothing to disclose.Conflict of interest: Dr. Maragna has nothing to disclose.Conflict of interest: Dr. Lo Russo has nothing to disclose.Conflict of interest: Dr. Bonomi has nothing to disclose.Conflict of interest: Dr. Sciomer has nothing to disclose.Conflict of interest: Dr. Agostoni reports non-financial support from Menarini, grants from Daiichi Sankyo, non-financial support from Novartis, non-financial support from Boeringer, grants and non-financial support from Actelion, grants from Bayer, outside the submitted work.