The Effect of N95 Respirators on Vital Parameters, PETCO2 and Physical
Comfort among Healthcare Providers at the Pandemic Clinics
Abstract
Background Wearing face shields and masks, which used to have very
limited public use before the Covid-19 outbreak, has been highly
recommended by organizations, such as CDC and WHO, during this pandemic
period. The aim of this prospective study is to scrutinize the dynamic
changes in vital parameters, change in end tidal CO2 levels, the
relationship of these changes with taking a break, and the subjective
complaints caused by respiratory protection while healthcare providers
are performing their duties with the N95 mask. Methods The prospective
cohort included 54 healthcare workers (doctors, nurses, paramedics) who
worked in the respiratory unit of the emergency department (ED),
performed their duties by wearing valved N95 masks, face shields. The
vital parameters and end-tidal CO2 levels were measured at 0-4th-5th-and
9th hours of the work-shift. Results Only the decrease in diastolic BP
between 0-9 hours was statistically significant (p=0.038). Besides, MAP
values indicated a significant decrease between 0-9 hours and 5-9 hours
(p= 0.024 and p=0.049, respectively). In terms of the vital parameters
of the subjects working with and without breaks, only PETCO2 levels of
those working uninterruptedly increased significantly at the 4th hour in
comparison to the beginning-of-shift baseline levels (p=0.003).
Conclusion Although the decrease in SBP and MAP values is assumed to be
caused by increased fatigue due to workload and work pace as well as
increase in muscle activity, the increase in PETCO2 levels in the ED
healthcare staff working with no breaks between 0-4 hours should be
noted in terms of PPE-induced hypoventilation.