Risks of N95 Face Mask Use in Subjects With COPD

Abstract

BACKGROUND: The N95 filtering facepiece respirator (FFR) is the most popular individual protective device to reduce exposure to particulate matter. However, concerns have been raised with regard to its use because it can increase respiratory resistance and dead space. Therefore, this study assessed the safety of N95 use in patients with COPD and air-flow limitation. METHODS: This prospective study was performed at a tertiary hospital and enrolled 97 subjects with COPD. The subjects were monitored for symptoms and physiologic variables during a 10min rest period and 6-min walking test while wearing an N95. RESULTS: Of the 97 subjects, 7 with COPD did not wear the N95 for the entire test duration. This mask-failure group showed higher British modified Medical Research Council dyspnea scale scores and lower FEV 1 percent of predicted values than did the successful mask use group. A modified Medical Research Council dyspnea scale score 6 3 (odds ratio 167, 95% CI 8.4 to >999.9; P 5 .008) or a FEV 1 < 30% predicted (odds ratio 163, 95% CI 7.4 to >999.9; P 5 .001) was associated with a risk of failure to wear the N95. Breathing frequency, blood oxygen saturation, and exhaled carbon dioxide levels also showed significant differences before and after N95 use. CONCLUSIONS: This study demonstrated that subjects with COPD who had modified Medical Research Council dyspnea scale scores 6 3 or FEV 1 < 30% predicted wear N95s only with care.

Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity

“…The increased breathing resistance, which is likely higher during stress, leads to an elevated breathing work and a limitation of the ventilation. The data of this study are obtained in healthy young volunteers, the impairment is likely to be significantly greater, e.g., in patients with obstructive pulmonary diseases [18]. From our data, we conclude that wearing a medical face mask has a significant impact on pulmonary parameters both at rest and during maximal exercise in healthy adults.…”

Face masks: benefits and risks during the COVID-19 crisis

“…The respiratory rate, oxygen saturation and CO 2 levels changed significantly while wearing N95/FFP2 masks. These results demonstrated the potential risks of wearing this type of mask in the presence of advanced COPD [19]. Their use should be recommended with caution in this patient population, a questionably relevant recommendation, since the use of these masks is limited to health care workers in direct contact with COVID patients.…”

Pratique des explorations fonctionnelles respiratoires pendant l’épidémie COVID-19. Prise de position du groupe « Fonction respiratoire » et du groupe « Alvéole » de la SPLF concernant la pratique de l’exploration fonctionnelle respiratoire au repos et à l’exercice, applicable à la phase de reprise d’activité

“…En revanche, le port d'un masque filtrant analogue à un masque FFP2 entraînait une augmentation de la PCO 2 transcutanée [19]. Chez les patients atteints de bronchopneumopathie chronique obstructive, le port d'un masque FFP2 est mal toléré [20]. À la lumière de ces données, il est proposé que la réalisation d'un test de marche de 6 min soit encadrée des mesures suivantes :…”