Evaluation of Capillary Blood Gases in Medical Personnel Caring for Patients Isolated Due to SARS-CoV-2 in Intensive Care Units before and after Using Enhanced Filtration Masks: A Prospective Cohort Study.

Wioletta Mędrzycka-Dąbrowska,Lucyna Tomaszek,Katarzyna Lewandowska,Katarzyna Zorena,Kamil Krzyżanowski,Przemysław Żuratyński,Sebastian Dąbrowski,Karina Chmielarz,Paulina Buca,Marlena Robakowska,Dorota Ozga,Daniel Ślęzak,Anna Małecka-Dubiela

doi:10.3390/ijerph18189425

Abstract

The dynamically changing epidemiological situation caused by the SARS-CoV-2 virus is associated with the increased burden and fatigue of medical personnel. The aim of the study was to evaluate: (1) oxygen and carbon dioxide blood pressure and saturation levels in medical personnel caring for patients isolated due to SARS-CoV-2 in ICUs; (2) adverse symptoms reported by medical personnel after leaving the isolation zone. Design: A Prospective Cohort Study. Methods: The project was implemented in the first quarter of 2021. Medical personnel working with patients isolated due to SARS-CoV-2 in the ICU of three hospitals were eligible for the study. The participants of the study were subjected to two analyses of capillary blood by a laboratory diagnostician. Results: In the studied group of medical personnel (n = 110) using FFP2/FFP3 masks, no significant differences (p > 0.05) were found between the parameters of geometric examination performed before and after leaving the isolation ward of the hospital. After working in the isolation ward, nurses reported malaise (somnolence, fatigue, sweating, dizziness) more often than paramedics (44% vs. 9%; p = 0.00002). The risk of ill-being in nurses was approximately nine times higher than in paramedics (OR = 8.6; Cl 95%: 2.7 to 26.8) and increased with the age of the subjects (OR = 1.05; Cl 95%: 1.01 to 1.08). Conclusion: FFP2/FFP3 filter masks did not worsen blood oxygenation in medical staff caring for patients isolated due to SARS-CoV-2 in the ICU. The presence of subjective symptoms such as fatigue may be due to lack of adequate hydration.

Highlights

The dynamically changing epidemiological situation caused by the SARS-CoV-2 virus is associated with the increased workload and fatigue of medical personnel
The purpose of this study was: (1) to evaluate the levels of oxygen and carbon dioxide pressure and saturation in arterialized capillary blood collected from medical personnel caring for patients isolated due to SARS-CoV-2 in the ICU; (2) to evaluate the adverse symptoms reported by medical personnel after leaving the isolation zone
All subjects were protected with protective equipment (PPE), with 29% wearing a mask with an FFP2 filter, 27% of subjects wearing a half-face mask with an FFP3 filter, and 44% of subjects wearing a full-face mask with an FFP3 filter

Summary

Introduction

The dynamically changing epidemiological situation caused by the SARS-CoV-2 virus is associated with the increased workload and fatigue of medical personnel. The use of a mask with enhanced filtration efficiency, a visor, goggles, a barrier apron, or a diagnostic suit and gloves should be considered appropriate personal protective equipment during routine care of a patient with a highly infectious acute respiratory infection [3,4]. Concerns have been raised among medical personnel regarding the adverse effects of the prolonged use of masks with enhanced filtration efficiency on pulmonary gas exchange [5,6]. To ensure proper homeostasis of the body, chemoreceptors in the respiratory center activate compensatory mechanisms to maintain acid-base balance and blood oxygenation within normal limits. This induces increased effort in breathing and hyperventilation. Most often the symptoms resolve spontaneously after the mask is removed; there are situations where medical intervention is necessary [7,8]

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