Personal protective equipment-induced systemic hypercapnic hypoxaemia: translational implications for impaired...

Area of Science:

• Medical Research
• Surgical Science
• Occupational Health

Background:

• Personal protective equipment (PPE) can negatively impact pulmonary gas exchange, potentially causing hypercapnic hypoxemia and headaches.
• The effects of PPE on cerebral symptoms, global cerebral blood flow, and cognitive performance in surgical settings are not fully understood.

Purpose of the Study:

• To investigate the extent to which type 3 PPE affects cerebral symptoms, global cerebral blood flow, and cognitive functional performance in higher surgical trainees.
• To compare the effects of standard operating attire versus type 3 PPE during simulated surgical tasks.

Main Methods:

• A randomized, repeated-measures, crossover study involving 31 higher surgical trainees.
• Participants completed 60-minute laparoscopic surgical simulations in both standard attire and type 3 PPE.
• Measurements included headache (VAS, ESQ-C), cerebral blood flow (duplex ultrasonography), and cognitive function (grooved peg board, laparoscopic bead board tasks).

Main Results:

• PPE significantly increased headache scores (VAS, ESQ-C) and impaired executive motor function (GPB-D, LSB task completion times).
• Wearing PPE led to increased heart rate and skin temperature, and decreased peripheral oxygen saturation.
• No significant differences in global cerebral blood flow were observed between PPE and standard attire, or across time or sex.

Conclusions:

• Type 3 PPE is associated with increased headache and cerebral symptoms, along with impaired executive motor function.
• These impairments, despite unchanged global cerebral blood flow, have clinical implications for cognitive-clinical performance in surgical settings.
• The findings underscore the need to consider the impact of PPE on surgical performance and patient safety.