Pritam Sukul, Julia Bartels, Patricia Fuchs, Phillip Trefz, Rasmus Remy, Leo Rührmund, Svend Kamysek, Jochen K Schubert, Wolfram Miekisch
European Respiratory Journal 2022; DOI: 10.1183/13993003.00009-2022
Background While assumed to protect against coronavirus transmission, face-masks may have effects on respiratory-haemodynamic parameters. Within this pilot study, we investigated immediate and progressive effects of FFP2 and surgical masks on exhaled breath constituents and physiological attributes in 30 adults at rest.
Methods We continuously monitored exhaled breath profiles within mask space in older (age: 60–80 years) and young to mid-aged (age: 20–60 years) adults over the period of 15 and 30 min, respectively by high-resolution real-time mass-spectrometry (PTR-ToF-MS). Peripheral oxygen saturation, respiratory- and haemodynamic parameters were measured (non-invasively) simultaneously.
Results Profound, consistent and significant (p-value≤0.001) changes in SpO2 (Adults>60_FFP2-15 min: 5.8±1.3%↓, Adults>60_surgical-15 min: 3.6±0.9%↓, Adults<60_FFP2-30 min: 1.9±1.0%↓, Adults<60_surgical-30 min: 0.9±0.6%↓) and pET-CO2 (Adults>60_FFP2-15 min: 19.1±8.0%↑, Adults>60_surgical-15 min: 11.6±7.6%↑, Adults<60_FFP2- 30 min: 12.1±4.5%↑, Adults<60_surgical- 30 min: 9.3±4.1%↑) indicate ascending deoxygenation and hypercarbia. Secondary changes (p-value≤0.005) to hemodynamic parameters (e.g. MAP: Adults>60_FFP2-15 min: 9.8±10.4%↑) were found. Exhalation of blood-borne volatile metabolites e.g. aldehydes, hemiterpene, organosulfur, short-chain fatty acids, alcohols, ketone, aromatics, nitrile and monoterpene mirrored behaviour of cardiac output, MAP, SpO2, respiratory rate and pET-CO2. Exhaled humidity (e.g. Adults>60_FFP2-15 min: 7.1±5.8%↑) and exhaled oxygen (e.g. Adults>60_FFP2-15 min: 6.1±10.0%↓) changed significantly (p-value≤0.005) over time.
Conclusions Breathomics allows unique physio-metabolic insights into immediate and transient effects of face-mask wearing. Physiological parameters and breath profiles of endogenous and/or exogenous volatile metabolites indicated putative cross-talk between transient hypoxemia, oxidative stress, hypercarbia, vasoconstriction, altered systemic microbial activity, energy homeostasis, compartmental storage and washout. FFP2 masks affected more pronouncedly than surgical masks. Older adults were more vulnerable to FFP2 mask induced hypercarbia, arterial oxygen decline, blood pressure fluctuations and concomitant physiological and metabolic effects.
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Conflict of interest: The authors have nothing to disclose.