Medicina Pulmonar e Respiratória

Use of Modified Full Face Scuba-Diving Mask in Patients with Respiratory Insufficiency due to COVID-19 Infection

Abstract

Maria Herrera, Jorge Alvarez, Alejandro Gutiérrez Jimenez, Nicolas Gonzalez Mangado, Marta Sanchez Menan* and Juan Rey

Background: The COVID-19 pandemic has made it necessary to implement new ways to increase the volume of oxygen delivered to infected patients with respiratory involvement. When treating individuals who are not candidates for intubation, we have found that modified scuba-diving masks may be used to treat those cases requiring over 15 liters of oxygen per minute, like compassionate use.

Methods: We describe the use of modified scuba-diving masks for ventilation on 13 patients at out hospital. None of them was candidate for ICU due to comorbidity and dependency.

Findings: Patients outfitted with this modified scuba-diving masks experience immediate clinical improvement, showing an increase in oxygen saturation from 80–84% to 96–98%, with isolated cases reaching 100% saturation. Preliminary results reveal hypercapnia closely resembling that seen with a normal reservoir as well as improved oxygen saturation. The clinical evolution was favorable.

Patients progressively decreased their oxygen supply needs: 8 of them have undergone this treatment for 8 days (4 patients has already been discharged; one maintains FiO2 28% with nasal cannula and 3 require intermittent treatment); 2 patients continue with the masks. 3 patients have died.

Interpretation: Through a series of adaptations, these masks may be used to increase the volume of oxygen delivered, thereby avoiding the use of a respirator or achieving more effective management of hospital resources in situations of potential disease transmission, such as the current pandemic situation in which we currently find ourselves.