Effect of surgical mask and N95 respirator mask use on cerebrovascular reactivity

Ideggyogy Sz. 2024 Jul 30;77(7-8):263-271. doi: 10.18071/isz.77.0263.

Abstract

Background and purpose: <p>Face masks are crucial parts of personal protective equipment (PPE) to reduce the risk of respiratory infections. The COVID-19 outbreak has increased healthcare workers&rsquo; use of face masks. This study aimed to evaluate changes in cerebrovascular response among healthcare workers using surgical and N95 respirator masks.&nbsp;</p>.

Methods: <p>90 healthcare workers: 30 wearing surgical masks, 30 wearing N95 respirators, and 30 without masks were included. After two-hour of face mask use, the baseline mean flow velocity (MFV) and the mean breath-holding index (BHI) of the bilateral middle cerebral arteries (MCAs) were evaluated with transcranial Doppler ultrasound. The presence of de-novo headache was recorded. BHI values ​​below 0.69 were evaluated as a sign of impaired cerebrovascular reactivity (CVR).&nbsp;</p>.

Results: <p>The rate of de-novo headache was significantly higher in the N95 respirator mask group (p = 0.004). Compared to the control and surgical mask groups, the N95 respirator mask group had significantly lower values of the baseline MFV of the right MCA (p = 0.003 and p = 0.021, respectively) and mean BHI (p = 0.003 and p = 0.012, respectively). Still, only one N95 respirator mask user had a mean BHI value below 0.69.</p>.

Conclusion: <p>Surgical masks did not signi&shy;fi&shy;cantly affect cerebral hemodynamics. Although N95 respirator mask use significantly decreased BHI values, the CVR is still within normal limits, and the development of de-novo headache is not directly associated with low CVR.&nbsp;</p>.

Background and purpose: <p>Az arcmaszkok a l&eacute;gzőszervi fertőz&eacute;sek kock&aacute;zat&aacute;nak cs&ouml;kkent&eacute;s&eacute;re alkalmazott szem&eacute;lyes v&eacute;dőfelszerel&eacute;s (PPE) elengedhetetlen r&eacute;sz&eacute;t k&eacute;pezik. A Covid-19-j&aacute;rv&aacute;ny hat&aacute;s&aacute;ra fokoz&oacute;dott az eg&eacute;szs&eacute;g&uuml;gyi dolgoz&oacute;k arcmaszkhaszn&aacute;lata. Tanulm&aacute;nyunk c&eacute;lja az volt, hogy &eacute;rt&eacute;kelj&uuml;k a seb&eacute;szeti &eacute;s az N95 respir&aacute;tor maszkot viselő eg&eacute;szs&eacute;g&uuml;gyi dolgoz&oacute;k k&ouml;r&eacute;ben bek&ouml;vetkező cerebrovascularis v&aacute;lasz v&aacute;ltoz&aacute;sait.</p>.

Methods: <p>&Ouml;sszesen 90 eg&eacute;szs&eacute;g&uuml;gyi dolgoz&oacute;t vontunk be a tanulm&aacute;nyba: 30-an seb&eacute;szeti maszkot &eacute;s 30-an N95 respir&aacute;tor maszkot viseltek, míg 30-an nem viseltek maszkot. K&eacute;t&oacute;r&aacute;s maszkhaszn&aacute;lat ut&aacute;n trans&shy;cranialis Doppler-ultrahanggal &eacute;rt&eacute;kelt&uuml;k a bilater&aacute;lis k&ouml;z&eacute;pagyi art&eacute;ri&aacute;k (MCA) &aacute;tlagos &aacute;raml&aacute;si sebess&eacute;g&eacute;t (MFV) &eacute;s &aacute;tlagos l&eacute;gz&eacute;start&aacute;si index&eacute;t (BHI). R&ouml;gzített&uuml;k a de novo fejf&aacute;j&aacute;s jelenl&eacute;t&eacute;t. A 0,69 alatti BHI-&eacute;rt&eacute;keket a k&aacute;rosodott cerebrovascularis reaktivit&aacute;s (CVR) jel&eacute;nek tekintett&uuml;k.&nbsp;</p>.

Results: <p>A de novo fejf&aacute;j&aacute;s előfor&shy;dul&aacute;si ar&aacute;nya szignifik&aacute;nsan magasabb volt az N95 l&eacute;gzőmaszkot viselő csoportban (p = 0,004). Az N95 l&eacute;gzőmaszkot viselő csoportban a jobb MCA &aacute;tlagos &aacute;raml&aacute;si sebess&eacute;g&eacute;nek kiindul&aacute;si &eacute;rt&eacute;ke (p = 0,003, illetve p = 0,021) &eacute;s az &aacute;tlagos BHI-&eacute;rt&eacute;kek (p = 0,003 &eacute;s p = 0,012) szignifik&aacute;nsan alacsonyabbak voltak a kontroll- &eacute;s a seb&eacute;szeti maszkot viselő csoportok &eacute;rt&eacute;keihez k&eacute;pest. Mindazon&aacute;ltal, csak egy N95 l&eacute;gzőmaszkot viselő szem&eacute;ly eset&eacute;ben volt az &aacute;tlagos BHI-&eacute;rt&eacute;k 0,69 alatt.</p>.

Conclusion: <p>A seb&eacute;szeti maszk hasz&shy;n&aacute;lata nem befoly&aacute;solta szignifik&aacute;nsan a ce&shy;rebralis hemodinamik&aacute;t. Hab&aacute;r az N95 l&eacute;g&shy;zőmaszk haszn&aacute;lata szignifik&aacute;nsan cs&ouml;kkentette a BHI-&eacute;rt&eacute;keket, a CVR-&eacute;rt&eacute;kek tov&aacute;bbra is a norm&aacute;ltartom&aacute;nyban voltak, &eacute;s a de novo fejf&aacute;j&aacute;s kialakul&aacute;sa nem volt k&ouml;zvetlen &ouml;sszef&uuml;gg&eacute;sben az alacsony CVR-rel.</p>.

Keywords: breath-holding index; cerebrovascular reactivity; healthcare workers; n95 respirator mask; surgical mask.

MeSH terms

  • Adult
  • COVID-19* / prevention & control
  • Cerebrovascular Circulation
  • Female
  • Headache / etiology
  • Headache / prevention & control
  • Health Personnel
  • Humans
  • Male
  • Masks*
  • Middle Cerebral Artery
  • N95 Respirators*
  • SARS-CoV-2
  • Ultrasonography, Doppler, Transcranial