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Improvement of arterial oxygenation using the double trunk mask above low flow nasal cannula: a pilot study

  • Frédéric DuprezEmail author
  • Simon Cocu
  • Alexandre Legrand
  • Serge Brimioulle
  • Shahram Mashayekhi
  • Gokhan Bodur
  • Arnaud Bruyneel
  • Jean Roeseler
  • Grégory Cuvelier
  • Grégory Reychler
Letter to the Editor
  • 6 Downloads

To the Editor,

The Double Trunk Mask (DTM) is an original mask (Fig.  1) which boosts the Fraction inspired in Oxygen (FiO 2) during oxygen therapy with high flow nasal oxygen (HFNO) [ 1]. In a previous study, the association of the DTM over HFNO showed an increase of the PaO 2 without PaCO 2 increase despite an added dead space of 210 mL due to the mask and the trunks. It can be explained principally by the washing of the trunks by the high flow (until 60 L/min). However, few studies have examined the effect of DTM on PaO 2 and PaCO 2 during oxygen therapy at low flow. Indeed, the use of low flow oxygen should lead to a risk of CO 2 rebreathing [ 2]. In fact, during expiration, the additional oxygen does not escape but is collected in the two trunks. During inspiration, the patient receives this oxygen-enriched gas mixture from the trunks instead of the air in the room. The DTM thus acts like a “reservoir” and results in increased FiO 2. However, thanks to its dead space volume, the DTM could...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

The study protocol has been approved by the Erasmes Hospital (Brussels) Ethics Committee.

Informed consent

Written consent was obtained from all the participants before inclusion.

References

  1. 1.
    Duprez F. The double trunk mask improves oxygenation during highflow nasal cannula therapy for hypoxemic acute respiratory failure. Respir Care. 2019;64:908.CrossRefGoogle Scholar
  2. 2.
    Campkin NT, Ooi RG, Soni NC. The rebreathing characteristics of the Hudson oxygen mask. Anaesthesia. 1993;48(3):239–42.CrossRefGoogle Scholar
  3. 3.
    Villar J, Slutsky AS. The incidence of the adult respiratory distress syndrome. Am Rev Respir Dis. 1989;140(3):814–6.CrossRefGoogle Scholar
  4. 4.
    Wallaert B, Wemeau-Stervinou L, Salleron J, Tillie-Leblond I, Perez T. Do we need exercise tests to detect gas exchange impairment in fibrotic idiopathic interstitial pneumonias? Pulm Med. 2012;2012:657180.CrossRefGoogle Scholar
  5. 5.
    Lumachi F, Marzano B, Fanti G, Basso SMM, Mazza F, Chiara GB. Relationship between body mass index, age and hypoxemia in patients with extremely severe obesity undergoing bariatric surgery. Vivo Athens Greece. 2010;24(5):775–7.Google Scholar
  6. 6.
    Van Meerhaeghe A, Sergysels R. Control of breathing during exercise in patients with chronic airflow limitation with or without hypercapnia. Chest. 1983;84(5):565–70.CrossRefGoogle Scholar
  7. 7.
    Dunn WF, Nelson SB, Hubmayr RD. Oxygen-induced hypercarbia in obstructive pulmonary disease. Am Rev Respir Dis. 1991;144(3 Pt 1):526–30.CrossRefGoogle Scholar
  8. 8.
    Abdo WF, Heunks LMA. Oxygen-induced hypercapnia in COPD: myths and facts. Crit Care Lond Engl. 2012;16(5):323.CrossRefGoogle Scholar
  9. 9.
    Sztrymf B, Messika J, Mayot T, Lenglet H, Dreyfuss D, Ricard J-D. Impact of high-flow nasal cannula oxygen therapy on intensive care unit patients with acute respiratory failure: a prospective observational study. J Crit Care. 2012;27(3):324.e9–13.CrossRefGoogle Scholar
  10. 10.
    Frat J-P, Thille AW, Mercat A, Girault C, Ragot S, Perbet S, et al. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med. 2015;372(23):2185–96.CrossRefGoogle Scholar
  11. 11.
    Vargas F, Saint-Leger M, Boyer A, Bui NH, Hilbert G. Physiologic Effects of high-flow nasal cannula oxygen in critical care subjects. Respir Care. 2015;60(10):1369–76.CrossRefGoogle Scholar
  12. 12.
    Brotfain E, Zlotnik A, Schwartz A, Frenkel A, Koyfman L, Gruenbaum SE, et al. Comparison of the effectiveness of high flow nasal oxygen cannula vs. standard non-rebreather oxygen face mask in post-extubation intensive care unit patients. Isr Med Assoc J. 2014;16(11):718–22.PubMedGoogle Scholar
  13. 13.
    Rittayamai N, Tscheikuna J, Rujiwit P. High-flow nasal cannula versus conventional oxygen therapy after endotracheal extubation: a randomized crossover physiologic study. Respir Care. 2014;59(4):485–90.CrossRefGoogle Scholar
  14. 14.
    Duprez F, Laghmiche A, Trimpont FV, Gatera E, Bodur G. Clinical evaluation of new ways of administration of oxygen: tusk mask II and double trunk mask. Prehosp Disaster Med. 2001;16(S1):S23–S2323.CrossRefGoogle Scholar
  15. 15.
    Duprez F, Bonus T, Cuvelier G, Machayekhi S, Ollieuz S, Sonck E, et al. Comparaison de la performance de trois masques à oxygène. Anesth Réanim. 2015;1:A314.CrossRefGoogle Scholar
  16. 16.
    Duprez F, Bruyneel A, Machayekhi S, Droguet M, Bouckaert Y, Brimioulle S, et al. The double-trunk mask improves oxygenation during high-flow nasal cannula therapy for acute hypoxemic respiratory failure. Respir Care. 2019;64(8):908–14.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2020

Authors and Affiliations

  • Frédéric Duprez
    • 1
    • 2
    • 3
    Email author
  • Simon Cocu
    • 3
  • Alexandre Legrand
    • 5
  • Serge Brimioulle
    • 4
  • Shahram Mashayekhi
    • 1
  • Gokhan Bodur
    • 6
  • Arnaud Bruyneel
    • 3
  • Jean Roeseler
    • 2
  • Grégory Cuvelier
    • 3
  • Grégory Reychler
    • 2
  1. 1.Department of Intensive CareEpicura HospitalHornuBelgium
  2. 2.Institut de Recherche Expérimentale Et Clinique (IREC), Pole de Pneumologie, ORL & Dermatologie, Service de PneumologieUniversité Catholique de LouvainBrusselsBelgium
  3. 3.Laboratory of Exercise and MovementProvincial School of Hainaut HEPH-CondorcetTournaiBelgium
  4. 4.Department of Intensive CareErasme Hospital, Université Libre de BruxellesBrusselsBelgium
  5. 5.Department of Physiology, Physiopathology and Respiratory Readaptation, Health InstituteUniversity of MonsMonsBelgium
  6. 6.Department of Intensive CareGroupe Hospitalier de La Région de Mulhouse Et du Sud-AlsaceMulhouseFrance

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