Comparison of tissue oxygenation achieved breathing oxygen using different delivery devices and flow rates

Blake, Denise F., Crowe, Melissa, Lindsay, David, Brouff, Annie, Mitchell, Simon, Leggat, Peter, and Pollock, Neal (2020) Comparison of tissue oxygenation achieved breathing oxygen using different delivery devices and flow rates. Diving and Hyperbaric Medicine, 50 (1). pp. 34-42.

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Abstract

Introduction: Divers with suspected decompression illness require high concentration normobaric oxygen (O2) as a treatment priority. There are many different O2 delivery devices, with little published data providing direct comparison of their performance.

Aim: To evaluate O2 delivery, using tissue O2 partial pressure (PtcO2), in healthy volunteer scuba divers while breathing O2 using three different commercially available delivery devices.

Methods: Twelve divers had PtcO2 measured at six limb sites. Participants breathed O2 from: a demand valve using an intraoral mask with a nose clip (NC); a first aid medical O2 rebreathing system (MORS) with an oronasal mask and with an intraoral mask; and a non-rebreather mask (NRB) at 15 or 10 L·min-1. In-line inspired O2 (FIO2) and nasopharyngeal FIO2 were measured. Participants provided subjective ratings of mask comfort, ease of breathing, and overall ease of use for each device.

Results: PtcO2 values and nasopharyngeal FIO2 (median[IQR]) were similar with the demand valve with intraoral mask, MORS with both masks and the NRB at 15 L·min-1. PtcO2 and nasopharyngeal FIO2 values were significantly lower with the NRB at 10 L·min-1. The NRB was rated as the most comfortable to wear, easiest to breathe with, and overall the easiest to use.

Conclusion: Of the commonly available devices promoted for O2 delivery to injured divers, similar PtcO2 and nasopharyngeal FIO2 values were obtained with each of the three devices tested: MORS with an oronasal or intraoral mask, demand valve with an intraoral mask and NRB at a flow rate of 15 L·min-1. PtcO2 and nasopharyngeal FIO2 values were significantly lower when the flow rate using the NRB was decreased to 10 L·min-1.

Item ID: 62683
Item Type: Article (Research - C1)
ISSN: 1833-3516
Keywords: Decompression sickness, Decompression illness, First aid, Masks, Medical kits, oxygen, Transcutaneous oximetry, scuba diving
Copyright Information: (C) This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive license to publish the article in electronic and other forms.
Funders: Emergency Medical Foundation (EMF), Divers Alert Network (DAN) Asia-Pacific
Date Deposited: 05 Apr 2020 23:59
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320299 Clinical sciences not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9299 Other Health > 929999 Health not elsewhere classified @ 80%
90 COMMERCIAL SERVICES AND TOURISM > 9003 Tourism > 900399 Tourism not elsewhere classified @ 20%
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