All about masks for non-invasive pulmonary ventilation (NIV)

The need for masks is not decreasing, but only growing, so everyone is trying to make money. But does a medical mask really protect?

Stars and Instagram bloggers are selling masks under their own brand for obscene amounts of money. Keti Topuria, Tina Kandelaki, the Little Big group and other famous personalities turned ordinary fabric masks into a fashion accessory with a price tag of up to 2,000 rubles.

Meanwhile, biochemists at the University of Manchester have developed a special snood bandage that destroys germs. It is much easier to breathe in it than in a mask. On March 2, the Ramensky Instrument-Making Plant, part of the Rostec corporation, announced the creation of innovative antimicrobial respirator masks with TIOKRAFT air purification technology. Once on the filter, any organic matter (including infection) decomposes into carbon dioxide and water. After 2 months they still haven’t gone on sale.

Doctors paid attention to protective face shields. On the one hand, they do not fit as tightly as a mask, but they have their advantages. Therapist, blogger, Philip Kuzmenko reminds that the screen also protects the eyes, unlike the mask. Doctor of Medical Sciences, immunologist-allergist Andrei Prodeus also believes.

Approach the choice of protective equipment with the due degree of responsibility.

Why do you need an oxygen concentrator?

Oxygen therapy is used for diseases accompanied by disturbances in the respiratory processes (ventilation of the lungs and gas exchange in their vessels), as well as in situations where independent breathing is impossible (during and after surgical interventions, injuries, disturbances of consciousness). There are non-invasive (external) and invasive (with oxygen delivery directly to the lower respiratory tract) methods of oxygen support. Non-invasive oxygen therapy is carried out using oxygen breathing devices: oxygen concentrators, oxygen cylinders and bags, devices for supplying oxygen into the respiratory tract under pressure, as well as through a centralized oxygen supply system in hospitals. Invasive oxygen therapy includes artificial pulmonary ventilation (ALV).

An oxygen concentrator is a convenient portable device for saturating the lungs with oxygen. You can use an oxygen concentrator not only in medical institutions, but also to breathe oxygen at home.

Compound

A bubble mask may include various components:

• Soda;
• Clay;
• Activated carbon;
• Snail slime;
• Aloe juice and pulp;
• Other useful substances.

The exact composition can be found on the packaging, where manufacturers are required to list all components. It is also important to pay attention to the position of caring components in the list of ingredients. The closer to the beginning of the list the beneficial substances are, the greater the percentage of content relative to the total mass of the product. If preservatives, flavors and other components predominate in the initial positions, and caring elements are at the end of the list, it is better to choose another mask.

Operating principle of an oxygen concentrator

The oxygen content in the air is 21%. The operating principle of an oxygen concentrator is to create a flow of pure oxygen for breathing. Air from the external environment passes through the water tanks of the oxygen apparatus, in which a breathing mixture with an oxygen content of about 95% is formed. The oxygen mixture is humidified and supplied to the patient through special tubes.

You can breathe oxygen through an oxygen mask that covers your nose and mouth, or through nasal cannulas (tubes that are inserted into your nostrils). The use of nasal prongs allows you to take food and water, as well as talk freely, without interrupting the oxygen therapy process.

Classic recipe

The main ingredient in oxygen masks is hydrogen peroxide . It is she who is the link between the skin and oxygen, helping it better penetrate inside. For such procedures, stock up on 3% peroxide.

Make flour from dry oatmeal, take 25 g, add 10 g of chamomile flowers, 15 g of white clay. Stir, add 100 g of water, 16 g of peroxide, distribute over desired areas.

You need to know your derma type. If it is dry, replace chamomile with lavender; if it is problematic, use green clay instead of white.

To check your skin type, wash your face, do not use cream, wait a while. If your face begins to feel tight, it means it’s dry; if an oily sheen appears, blot it with a paper napkin. Is there any fat left? That means fat. If your cheeks feel tight and the T-zone starts to shine, it’s a mixed type. If no significant changes occur, then it is normal.

Almond

• Grind 25 g of oatmeal and almonds in a blender.
• Add 10 g rose petals, 15 g cosmetic clay, 100 ml water, 10 ml peroxide.
• Mix well and apply to desired areas. The condition of your skin will noticeably improve.
• Regular procedures will help completely restore water balance and blood circulation.

Whitening

• This product is more suitable for normal to oily skin. Beat the chicken protein with a mixer until foamy.
• Combine it with 10 g shaving cream, 16 g peroxide. Distribute over desired areas, rinse after 5 minutes.
• This procedure tones, cleanses the skin, and removes pigmentation.

Anti-inflammatory

• Place 4 g of bodyaga in a glass container. Gradually add peroxide until creamy.
• Apply to skin. Keep it on for 5 minutes, rinse with water. You will get instant results because you use two active ingredients.
• They do the job well, but are also very aggressive, so be careful and stick to the recipe when using them.

Second option

Another effective anti-inflammatory agent is a mixture of baby powder (30 g) with peroxide. Mix the ingredients to a creamy mass and use as directed. This mixture is more gentle and suitable for problem skin.

To make the procedures as effective as possible, perform them 2 times a week for 2 months, then take a two-week break.

Judging by the reviews, the oxygen facial mask “Beauty style” has proven itself well and works effectively. You can purchase a portioned package with two packages: gel and powder. When they are mixed, a reaction begins. The product should be immediately applied to a cleansed face. The mass will begin to foam and increase in size. Leave it on for 10 minutes, then rinse with running water.

Result: the skin becomes moisturized, fresh, and the pores are narrowed. To feel the lifting effect you need to complete a course of 10 procedures.

Oxygen facial mask “Lumene”

produces high-quality oxygen masks. You can purchase 150 ml packaging or 4 ml samples. Users leave positive reviews about this product. The effectiveness is noticeable after the first procedures.

"Facezine"

“Facezine” - an oxygen facial mask made in Korea also captivated fans with its quality and composition. The most popular masks were those with green tea and latte. Green tea is suitable for oily faces, latte - for dry ones. Sold in small packages. It is economical because after the first use you will understand whether it is suitable for you or not.

Try making a moisturizing, nourishing or cleansing face mask.

Indications for oxygen concentrator

An oxygen support device is necessary for respiratory (pulmonary) failure. Respiratory failure is a pathological condition in which the level of oxygen in the blood decreases (saturation) and oxygen starvation of organs and tissues develops.

An oxygen concentrator may be needed for acute and chronic diseases of the cardiovascular and pulmonary system pathologies. Indications for the use of oxygen therapy through an oxygen concentrator include:

• acute respiratory distress syndrome;
• viral and bacterial pneumonia (including those caused by the Covid-19 virus);
• bronchial asthma;
• chronic obstructive pulmonary disease;
• bronchiolitis;
• bronchiectasis;
• idiopathic pulmonary fibrosis;
• cystic fibrosis;
• pulmonary edema;
• heart failure.

A decrease in oxygen in the blood is accompanied by complaints of shortness of breath and a feeling of lack of air. A drop in saturation is also accompanied by rapid breathing and heartbeat, pallor and a bluish tint of the skin (primarily the lips and fingertips turn blue), severe weakness, heart pain and a feeling of anxiety.

Doctor of Medical Sciences, Professor of the Department of Phthisiology and Pulmonology of the Medical Faculty of Moscow State Medical University, Sergey Lvovich Babak

Degree of oxygen deficiency relative to saturation (SpO2) - pulse oximeter readings

*Recommendations, the required oxygen flow, the regimen and duration of oxygen therapy for COPD are prescribed by the attending physician! Oxygen therapy at home is carried out using oxygen concentrators under the control of pulse oximeter readings.

— My name is Babak Sergey Lvovich. I am a professor at the Department of Phthisiology and Pulmonology of the Medical Faculty of Moscow State University of Medicine A.I. Evdokimov. I have several questions that I would like to devote the remaining time to. The role of oxygen in human daily life. The fact is that those mechanisms that we usually evaluate as oxidative are impossible without oxygen. Life is built around oxygen.

It exists in different forms. There are concepts of atomic oxygen, and there are concepts of molecular oxygen. The most curious thing is that molecular oxygen in the air in the lungs turns into atomic oxygen, which penetrates the blood and delivers it to the muscles. And already inside the muscles, it actively participates in the craps chain, allowing the body to receive the necessary proteins, fats, carbohydrates and nutrients by oxidizing products entering the body with food, water, liquids, and so on. Therefore, this delivery of oxygen by the lungs to the blood performs the function of gas exchange.

This is the most important function, and in short, why we breathe. We breathe only to maintain the constancy of atomic oxygen inside our body. The human lungs are adapted to inhale air at a pressure of one atmosphere containing 21% oxygen, almost 80% nitrogen and not containing any additional other impurities in the form of smoke, in the form of solid particles, and so on. But having a humidity of no higher than 60% at a temperature of about 22 degrees.

There are so many conditions necessary for the lungs in order to transform molecular oxygen into atomic oxygen and create a constant saturation of arterial blood with oxygen. If a person, for example, smokes or inhales some dust particles, or some other impurity components in the air, then the lungs react very harshly to this and do not allow such people to have an adequate level of arterial blood oxygen saturation. That is, it seems to be fighting to ensure that we still breathe the freshest air without pathogenic impurities or foreign particles. The second very important component that should be discussed when we talk about the role of oxygen in daily human life concerns environmental humidity and temperature.

The fact is that humans are adapted to live and survive in different climatic conditions. In conditions of very high humidity, in conditions of low humidity, in conditions of cold temperatures, in conditions of very hot temperatures. In fact, this is a unique creature with a high adaptive reserve. Almost all pulmonary diseases can be accompanied by the development of respiratory failure.

The essence of respiratory failure comes down to the fact that there is a discrepancy between the need for oxygen and the ability to deliver oxygen to the arterial blood. The partial tension of arterial blood with oxygen is less than 55 ml of mercury or an increase in the partial tension of carbon dioxide in the arterial blood is above 45 ml of mercury. These two parameters indicate that a person has experienced some degree of respiratory failure.

To our joy, there is an indirect method, but it is quite accurate, by which we can also find out what the degree of respiratory failure is. This method is called pulse oximetry. Pulse oximetry reflects the saturation of arterial blood with oxygen in the degree of saturation. This degree can also suggest the degree of respiratory failure, for example, arterial blood oxygen saturation in the range from 90 to 93% corresponds to a partial blood oxygen tension of 60 to 80 ml of mercury. Which corresponds to zero degree of respiratory failure.

The parameter of reducing blood saturation to 85% will correspond to the first degree of respiratory failure or a reduction to the level of 50 ml of mercury. A parameter of up to 80% blood saturation usually corresponds to the second degree of respiratory failure and 75% below blood oxygen saturation corresponds to the third degree of respiratory failure. It is believed that no matter how the patient feels, the degree of saturation of arterial blood with oxygen

should not be below 90% arterial blood oxygen saturation. The disease will proceed differently in a person if his arterial blood oxygen saturation is below 90%, that is, a certain degree of respiratory failure will occur.

What diseases are usually accompanied by respiratory failure? First of all, obstructive pulmonary diseases. These include bronchial asthma, they include obstructive bronchitis, they include chronic obstructive pulmonary disease, they include bronchiectasis, they include cystic fibrosis. How common is respiratory failure in the population?

It is impossible to give a direct answer here. Because we are talking about the prevalence of the disease, not the prevalence of the syndrome. Respiratory failure is a syndrome and it is quite difficult to separately calculate the prevalence of the syndrome. If we are talking about the comparison of diseases in which respiratory failure can occur, then this is almost 80% of all pulmonary diseases we encounter among the human population.

Therefore, we can say that the data is extrapolated from the given blood. To say that respiratory failure is a common phenomenon in obstructive pulmonary diseases. What underlies the development of respiratory failure? Primarily there are two main mechanisms. The mechanism of narrowing of the bronchi and the impossibility of bleeding out air containing 21% oxygen and the second mechanism is very important, this is the impossibility of oxygen penetrating through the alveolar membranes.

Here are the two main components influencing the development of respiratory failure. Therefore, we divide it into two different types that occur with obstructive pulmonary diseases, which occur with interstitial lesions of the lung tissue. Let's try to decipher the obstructive component of the development of respiratory failure. What is this connected with? First of all, it is due to the fact that in a number of diseases there is a narrowing of the lumen of the bronchial tree, a narrowing of the lumen of the bronchial tubes.

It's caused by bronchospasm, it's caused by swelling, mucus buildup. These three mechanisms lead to a narrowing of the lumen and the impossibility of air entering the respiratory tract. Therefore, even under normal conditions, when there is enough oxygen in the air to ensure the gas exchange function, it physically cannot penetrate the lower part of the respiratory system and saturate the blood with oxygen. Due to the fact that the development of certain respiratory volumes necessary to maintain the gas exchange function is not achieved.

The second situation is completely different; it is associated with intersocial lesions of the lung tissue. When tidal volume is reduced due to compression of the lung. The lung seems to be compressed a little on one side, and on the other side the membranes thicken and oxygen, at a pressure of one atmosphere, cannot penetrate through the membranes and penetrates worse than it should penetrate, cannot adequately saturate the arterial blood with oxygen. In both cases, increasing the concentration of the oxygen mixture supplied to the lungs leads to a very interesting effect.

Oxygen penetrates into the blood at a higher rate and practically the person loses respiratory failure. Therefore, we are talking specifically about devices in this case that are capable of creating an increased concentration of oxygen in the exhaled mixture; they are called an oxygen concentrator. A separate category is respiratory failure caused not by the oxygen component, but by the accumulation of carbon dioxide, it is called hypercapnic respiratory failure.

The first type of respiratory failure that we talked about before is called hypoxemic or hypoxic respiratory failure, where oxygen does not penetrate into the blood, low concentrations. And the second type of respiratory failure is called hypercapnic, associated with the accumulation of carbon dioxide. The culprit of the protogynesis of the development of this type of respiratory failure is precisely the respiratory muscle. A person cannot physically create an excursion adequate to the need for air oxygen to penetrate the respiratory tract.

This is usually associated with neuromuscular diseases, very often associated with obesity or with damage to the skeletal structure of the chest. Also plays an important role in the expansion of the lungs. How does respiratory failure manifest itself clinically? First of all, a person feels a feeling of lack of air, which has an organic name - shortness of breath. Shortness of breath occurs at rest, shortness of breath occurs during physical activity, so we grade this shortness of breath on a certain scale. We assign a point score, the higher the score, the more severe the person’s shortness of breath

In total, the scale provides four points, starting from two points, shortness of breath is chronic and is a reason to seriously think about the causes of such shortness of breath. Clinical shortness of breath manifests itself, if you look at such a patient with shortness of breath, you will see that there is usually bluish skin, blue lips, and often puffs.

True, in some diseases , chronic obstructive pulmonary diseases, in which shortness of breath is very characteristic, we even distinguish two different phenotypes of such a disease. One phenotype is called pink puffing patients, and the other is called blue panting patients. The pink ones that puff are called Pinkpuffers, and the blue ones that pant are called Blue Blowers.

So, Blue Blowers usually have a hypoxemic type of respiratory failure, they are cyanotic, the air supply is very useful for them. Pink-puffing patients more often have a hypercapnic type of respiratory failure with CO2 accumulation and oxygen in this case is not very useful. But on the contrary, it is necessary to have ways to strengthen the disabling part. That is, by changing the ventilation of the lungs in order to flush out CO2 in such patients, since the accumulation of oxygen in the blood causes an increase in the level of CO2 in the blood.

Frequency and seasonality of diseases causing respiratory failure. If we talk about the frequency and seasonality of these diseases, then, in my opinion, these diseases should still be divided into two main categories: obstructive diseases and restrictive diseases with damage to the lungs. If we are talking about the obstructiveness of the disease, then of course, first of all, they are associated with changes in humidity and ambient temperature.

Since this leads to the fact that sputum can swell in the lumen of the bronchus and clog small bronchi, this causes disturbances in the flow of air through the bronchial tree. Therefore, patients usually have chronic obstructive bronchitis twice a year. COPD has this type of exacerbation associated with climate change. A very important component influencing the frequency of exacerbations is continued smoking; such patients have obstructive diseases.

Regular inhalations of toxic gases and fumes support very pronounced inflammation in the respiratory tract and it overlaps with the course of treatment of the disease itself, causing an increase in the frequency of exacerbations. In this case of exacerbation of the disease, there is a sharp increase in shortness of breath, an increase in the secretion of sputum mucus more than usual, this causes the patient to begin to choke and experience varying degrees of respiratory failure.

With which he usually comes to our hospital or is subject to treatment at home. Seasonality in this case is not as important as maintaining those factors that can maintain inflammation of the respiratory tract. The situation is completely different with such an obstructive disease as bronchial asthma. This is a separate category of patients who are usually allergic and have hay fever, and at the moment of flowering of herbs, plants and flora, to which they react very sharply, they experience an exacerbation of bronchial asthma.

Exacerbations are associated specifically with the allergic component, and much attention is paid to the concept of a hypoallergenic regime in patients with asthma, maintaining this and combating hay fever or a reaction to flowering plants, all kinds of herbs, trees, and so on. If we are talking about restrictive diseases, such as pulmonary fibrosis, then they have neither frequency nor seasonality of exacerbation, the process is associated with something else.

The process is often associated with an additional infection, which the patient can get due to a cold or a viral infection. We are essentially talking about pneumonia, pneumonia. Pneumonia in such patients is very severe and very often patients are tormented by destructive diseases; when they get pneumonia, they get a very pronounced degree of respiratory failure. And they literally die from lack of oxygen in the arterial blood.

It must be said that oxygen is a medicine. Like every medicine, it must be considered as a kind of poison, which is given little by little under certain conditions. Since the principle of doing no harm should work in this case too. You can’t just breathe in a certain volume or flow of oxygen. In this way, you can seriously disrupt the humidity of the respiratory tract and disrupt the structure of the respiratory tract, causing yourself serious harm. Oxygen is a powerful oxidizing agent. I would really like our listeners and viewers to remember that the ozone you are talking about: “It’s very good to breathe ozone.”

- This is a big deal! Tragic mistake! There are many people who specially ozonate the room, creating so-called three-molecular oxygen. They damage the pulmonary apparatus so severely that they can eventually die from severe damage to the lung tissue from ozone breathing. Therefore, any oxygen therapy requires clear, specific intervention from a doctor.

Flow intensity. What flow intensity should be set in order to achieve success in oxygen therapy?

The oxygen flow should be such that arterial oxygen saturation figures range from 90% to 95% arterial oxygen saturation. If you can achieve this flow of one and a half liters per minute, that is enough. There is no need to increase the flow to 2 liters, 3 liters, 4 liters. If 3 liters are needed for this, conditions must be created so that the patient receives 3 liters. Therefore, in each specific case, there is a titration or selection of the oxygen flow that creates normal blood oxygen saturation figures. It is believed that flows in excess of one and a half liters per minute are unsafe. That is, they require a special air humidification system, since they can dry out the respiratory tract. And it requires warming, because it will lead to cooling of the respiratory tract.

Let me give you a simple example. For example, cooling the respiratory tract by one degree, that is, 37.4 there becomes 36.4. This leads to a decrease in air humidity by 12%. A decrease of 12% actually dries out the mucus, it becomes in the form of crusts, these crusts will never leave the lower respiratory tract, and respiratory plugs form. Or we call it a mucus plug.

Therefore, it is very important that we properly deliver oxygen to the airways. Properly humidify and, if necessary, properly warm the delivered air so as not to cause hypothermia of the respiratory tract. You need to consult a specialist, a doctor first of all, who knows this technology. And set the parameters necessary for this type of treatment.

How to prescribe oxygen therapy, which patients to prescribe and how to choose the right level? There is a concept of diphomysioma test, if the diffusion of oxygen decreases, we see a significant decrease. That is, the percentage of blood becomes below 55 ml. mercury, then long-term oxygen therapy is indicated for such patients. What is the best way to titrate the level of such therapy? During titration, the oxyinter course is used, which allows one to accurately determine the oxygen flow that maintains normal levels of oxygen saturation in arterial blood.

The need for long-term therapy arises in all patients with respiratory failure starting from the second stage. Since at this stage the arterial blood oxygen tension decreases, usually below 55 ml. mercury column. In fact, these are all patients admitted to the hospital with exacerbation of chronic obstructive pulmonary disease, exacerbation of obstructive bronchitis or with severe attacks of bronchial asthma. They will need oxygen therapy.

If we are talking about the duration of such a maneuver, the duration of this technique, it is important to look at the life-sustaining technique and the technique carried out for some time. Naturally, if we expect that the patient’s respiratory function will be restored and gas exchange will be restored, then we will cancel such therapy.

Usually when therapy takes about two, three weeks of oxygen therapy. We carry out this therapy in the hospital and upon discharge the patients do not receive further oxygen. But a number of patients, especially with interstitial lung lesions with severe obstructive disorders, when it is impossible to replenish gas exchange, require lifelong use of this type of therapy.

And then they are forced to use oxygen concentrators at home. This is an important factor in prolonging the life of such patients. It has been studied and shown that the use of an oxygen concentrator at home prolongs the patient’s life by 15-20 years. This is significant for such patients, while the degree and risk of exacerbations are reduced by up to four times.

That is, if a patient has a minor exacerbation per year, using long-term oxygen therapy for virtually the entire year, he does not experience any serious exacerbations of disease requiring hospitalization or a change in the amount of drug therapy.

This is a significant contribution of the duration of oxygen therapy or oxygen therapy to the doctrine of treatment of patients with chronic respiratory failure. There are oxygen concentrators operating in the range from one liter to five liters per minute with a high output concentration. Creating conditions for good saturation of arterial blood with oxygen. They are expensive and the patient does not have the money to purchase such a device; he is limited to simple concentrators that either work unstably, with a low oxygen concentration at the outlet, or do not provide a flow of, say, five to three and a half, four liters per minute.

What does this lead to? It leads to the fact that the real oxygen concentration in the inhaled mixture drops to a very low value and is virtually no different from room air. And we know very well that the patient’s room air is not enough to relieve gas exchange disorders in such a patient. And respiratory failure progresses in such patients, despite the fact that they supposedly use oxygen concentrators in their lives and are treated with the help of concentrators. In this case, we suggest renting an oxygen concentrator; the cost of renting an oxygen concentrator starts from 6,000 rubles per month.

Therefore, it is the reliability, the percentage reliable benefit of oxygen, the wide variation of flows of oxygen devices that allows you to have some maneuver. In order to select for each patient, in each specific case, adequate, reliable oxygen therapy for a very long period of use. One of the companies that has legalized such a line is the Agmung company. Which adopted the doctrine of various oxygen concentrators for various treatment methods.

For example, there is a model line of concentrators for hospitals and home use, for example, where fairly high flows are combined with a very high concentration of the inhaled oxygen mixture.

And there are oxygen concentrators for home use, small, portable, low noise, when the flow ranges from one to three liters per minute.

I note that usually for home use, flows of more than one and a half liters per minute are not used. Therefore, oxygen supplied in a flow of even three liters per minute is twice the patient’s needs, which provides a guarantee of reliability and stability for such patients, even in emergency situations happened at home. It is important to understand that sometimes patients themselves must know how to behave correctly in the current situation. For example, with a feverish patient, he puts a thermometer or thermometer under the armpit or in the mouth and determines the temperature for himself, understands that with a temperature of 37. he behaves according to one, with a temperature of 38 for another, 39 for a third.

Question: — How should a patient with respiratory failure who is receiving long-term oxygen therapy behave correctly?

For this, there are the concepts of pulse oximeters, a small portable device located on the phalanx of the finger, and allowing to measure the saturation of arterial blood with oxygen. So, if the patient feels increasing shortness of breath without receiving oxygen, puts a pulse oximeter on the phalanx of the finger and sees that the pulse and oximetry indicators begin to decrease below 90%. This is a reason to reconsider the scope of such therapy, but in the presence or after consultation with your doctor who prescribed this type of long-term oxygen therapy.

If he feels some kind of ailment, some kind of weakness, fatigue, but pulse oximetry is maintained above 90% of arterial blood oxygen saturation, then there is no need to change the volume of such therapy. These symptoms are associated with another manifestation of the disease, for example, with not receiving a bronchodilator, receiving hormonal therapy, or impaired mucus drainage in the respiratory system, but are in no way associated with long-term oxygen therapy.

Such a simple method of monitoring well-being and blood oxygen saturation makes the patient confident in the regularity and reliability of this type of treatment.

How long does it take to supply oxygen to a person's respiratory tract?

Professor Ludo in the early 80s in France conducted a huge clinical study on a huge sample of patients and it was established. That with long-term oxygen therapy, it is necessary to supply oxygen to the respiratory tract twenty hours a day, at least twenty hours a day, so that respiratory failure undergoes correction.

At the same time, if we reduce the number of hours of oxygen therapy to 15 or less, then this is equivalent to as if we did not conduct such sessions of long-term oxygen therapy at all.

That is, the boundaries of behavior range from 15 to 24 hours a day. And the desired duration is twenty hours during which the patient breathes a certain concentration of oxygen to relieve any degree of respiratory failure.

What should the saturation be?

Saturation is a measure of the amount of oxygen in the blood. The norm of saturation in adults is 95-100%. The oxygen levels in the blood change with changes in altitude due to the influence of atmospheric pressure on the ability of gases (including oxygen) to dissolve in liquids (blood).

Saturation is measured using pulse oximetry. A portable pulse oximeter for adults is usually worn on a finger. Deviations of saturation from the norm in healthy people can be observed when:

• the presence of a manicure coating on the nails (materials for covering the nails block infrared radiation, which is used in the pulse oximeter);
• cold fingers (in a cold room, outside during the cold season, with Raynaud's syndrome);
• arrhythmias;
• finger deformities (for example, with osteoarthritis);
• hand tremors (with parkinsonism).

Saturation below 92% is considered critical. Respiratory failure leads to a decrease in the supply of oxygen to tissues and organs, as a result of which the functioning of all body systems is disrupted. First of all, the organs of the central nervous system (brain) suffer from a lack of oxygen.

There is no single indicator of saturation that would be considered lethal. A person’s tolerance to oxygen starvation depends on the general health of the body, the presence of chronic diseases, the duration of respiratory failure (with chronic respiratory failure, adaptation to low levels of oxygen in the blood occurs), and level of training (trained people tolerate respiratory failure more easily).

Improved use of three-way infusion stopcock

In the video I showed the possibility of connecting oxygen tubes to this tap, but it is obvious that there is an oxygen leak. Bill Murphy, physician extraordinaire, wrote to me on how to improve this connection. Cut off the thick part of the oxygen circuit. You will need to work with the oxygen circuits that your hospital has to find the best location for the cut. Once you have the leak sorted out, you can make a sealed connection without a universal tube to the Luer lock adapter.

Oxygen concentrator for Covid

Coronavirus infection caused by the SARS-CoV-2 virus affects the alveoli of the lungs (the lung sacs in which gas exchange occurs). Infection of the lungs with coronavirus leads to the formation of interstitial, usually bilateral, pneumonia. An area of ​​lung tissue susceptible to inflammation cannot participate in the act of breathing, which leads to a decrease in saturation. The saturation rate for Covid is the same as for healthy people - over 95%.

An oxygen concentrator for Covid is necessary if respiratory failure develops. Connecting to oxygen during Covid at the stage of the first signs of decreased saturation allows you to avoid the negative consequences of hypoxia and slow down the progression of the inflammatory process in the lungs. It is necessary to breathe oxygen correctly during Covid, observing the duration of oxygen therapy and the operating mode of the device prescribed by the doctor. Oxygen therapy by breathing oxygen during covid may be required not only at the height of pneumonia, but also at the stage of resorption of pneumonia. The duration of treatment is individual and can last more than one month.

Types of bubble masks

Bubble masks differ in composition, effect, and external manifestation of foaming. There are also several types of release form:

• Textile. Disposable, they need to be wetted and then applied to the face.
• Paste. Creamy, reusable composition. Apply dosed onto hands and spread over face. Some manufacturers' bottles are equipped with special pumps for dosed consumption of the product.

Masks in paste form work better. The fabric base does not allow the composition to act on the skin directly, penetrating deep into the skin.

Oxygen concentrator for pneumonia

Oxygen support may be necessary for pneumonia of any nature: viral, bacterial, fungal. An oxygen concentrator for pneumonia is indicated only in the presence of respiratory failure.

Oxygen therapy for pneumonia allows you to maintain sufficient oxygen saturation in the blood during a period when the lungs cannot cope with providing the body with oxygen without external support. It is necessary to breathe oxygen during pneumonia until good saturation is restored.

Peculiarities

The foaming effect not only makes using a bubble mask a pleasant experience. It increases the saturation of the upper layers of the epidermis with oxygen, improves the penetration of active ingredients into the skin. Main features of the funds:

• In the paste form, the packaging is enough for 20-25 applications. This is several months of effective skin care.
• The absorbents in the composition help the skin to be deeply cleansed, removing remaining dirt and sebum. Thanks to its foam-like structure, beneficial components quickly penetrate the cells, nourishing them.
• There is no drying effect. Masks are very gentle and do not remove moisture from the dermis, only impurities.

Most often, bubble masks are chosen by people with oily, problematic skin, rashes, and blackheads.

How to breathe correctly with an oxygen concentrator?

Recommendations on how to properly breathe with an oxygen concentrator are given by the doctor who prescribes oxygen therapy. The therapist calculates the volume of oxygen that should enter the respiratory tract per unit of time (one minute), depending on the initial level of saturation and the severity of the patient’s condition. In addition to the oxygen flow rate, the doctor prescribes an oxygenation mode (continuous, during night sleep or after physical activity). You cannot use the oxygen concentrator yourself without a doctor’s prescription.

There are no absolute contraindications to oxygen therapy through an oxygen concentrator. However, supplemental oxygen at normal saturation levels can be toxic, so oxygenation is contraindicated in patients with pneumonia without signs of respiratory failure. If the oxygen concentrator is used incorrectly, it can cause harm to health.

For outpatient treatment and there are indications for oxygen inhalation, the doctor may recommend renting an oxygen concentrator for home use during the illness. Renting an oxygen concentrator should only be carried out in medical institutions that guarantee the quality of oxygen devices. The oxygen device must be certified. A rented oxygen breathing apparatus must be equipped with an individual mask or nasal prongs.

How to wear a mask correctly on the street, in an elevator and in a store

Wearing a mask correctly is no less important than having one.

The recommendations given by WHO are clear and understandable:

1. We hope. Wash your hands with soap or use an antiseptic. We put on the mask so that it fits as tightly as possible.
2. We wear it. We do not touch the mask or adjust it. If this happens, repeat the hand treatment. A damp mask must be replaced; reuse is not advisable.
3. We're filming. To remove the mask, grab the elastic bands from the back (without touching the mask itself). Throw it into a closed waste container, then sanitize your hands or wash with soap.

Virus filters

• All of the above sections mention filters.
• In our clinic, we use Intersurgical Filta-Guard filters with a viral filtration rate of 99.999%.
• Your department should have similar filters.
• You must be confident that the virus filters used in your hospital are effective against COVID-19.

This is a potentially risky moment. Follow the instructions of the “observer” to avoid re-contamination after successful respiratory support. Use the buddy protocol.