Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 25 , ISSUE 11 ( November, 2021 ) > List of Articles


Oxygen Administration under Surgical Face Mask in COVID-19 Patients: A Game Changer

Murugan Koushik, Ramachandran Meenakshisundaram, Narendra Nath Jena

Keywords : Acute hypoxemic respiratory failure, COVID-19, COVID-19 patient, Oxygen saturation, Pulse oximeter

Citation Information : Koushik M, Meenakshisundaram R, Jena NN. Oxygen Administration under Surgical Face Mask in COVID-19 Patients: A Game Changer. Indian J Crit Care Med 2021; 25 (11):1286-1287.

DOI: 10.5005/jp-journals-10071-24011

License: CC BY-NC 4.0

Published Online: 16-11-2021

Copyright Statement:  Copyright © 2021; The Author(s).


COVID-19 is a multifaceted infectious disease. The development of hypoxemic respiratory failure is not uncommon during the course of illness in some of them. The objectives of the present study were to assess the effect of the addition of a surgical face mask while delivering oxygen via nasal cannula in hypoxemic COVID-19 patients and highlight on the advantages and patient's comforts. We prospectively assessed 30 consecutive conscious and hypoxemic COVID-19 patients, requiring oxygen via nasal cannula. The mean PaO2 without and with surgical face mask were 52 (+9) and 83 (−12) mm Hg respectively in the cohort, and the elevation in oxygen saturation was statistically significant (p <0.001). The present results encourage the delivery of oxygen under the surgical face mask in symptomatic COVID-19 patients, as it improves oxygen saturation and prevents aerosol dispersion with no change in PaCO2. The other advantages of this method are a reduction in the total requirement of oxygen per patient, better utilization of scarce resources, and lessening of the expenses incurred for oxygen.

  1. Montiel V, Robert A, Robert A, Nabaoui A, Marie T, Mestre NM, et al. Surgical mask on top of high-flow nasal cannula improves oxygenation in critically ill COVID-19 patients with hypoxemic respiratory failure. Ann Intensive Care 2020;10(1):125. DOI: 10.1186/s13613-020-00744-x.
  2. Hamada S, Tanabe N, Hirai T. Effects of combined oxygen and surgical masks on inspired fraction of oxygen: relevance to COVID-19-induced respiratory failure. Br J Anaesth 2021;126(6):e215–e217. DOI: 10.1016/j.bja.2021.02.025.
  3. Matsui Y, Takazawa T, Takemae A, Saito S. Does a surgical mask improve oxygenation in COVID-19 patients? JA Clin Rep 2021;7(1):34. DOI: 10.1186/s40981-021-00439-7.
  4. Kumar H, Spence CJ, Tawhai MH. Modeling the pharyngeal pressure during adult nasal high flow therapy. Respir Physiol Neurobiol 2015;219:51–57. DOI: 10.1016/j.resp.2015.06.011.
  5. Adams CF, Geoghegan PH, Spence CJ, Jermy MC. Modelling nasal high flow therapy effects on upper airway resistance and resistive work of breathing. Respir Physiol Neurobiol 2018;254:23–29. DOI: 10.1016/j.resp.2018.03.014.
  6. Leonard S, Atwood CW, Jr, Walsh BK, DeBellis RJ, Dungan GC, Strasser W, et al. Preliminary findings on control of dispersion of aerosols and droplets during high-velocity nasal insufflation therapy using a simple surgical mask—implications for the high-flow nasal cannula. Chest 2020;158(3):1046–1049. DOI: 10.1016/j.chest.2020.03.043.
  7. Binks AC, Parkinson SM, Sabbouh V. Oxygen: under or over a surgical facemask for COVID-19 patients? Anaesthesia 2020;75(12):1691–1692. DOI: 10.1111/anae.15166.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.