TP10.1.12Personal Protective Equipment impairs pulmonary gas exchange causing systemic hypercapnia-hypoxaemia and cerebral hyperperfusion-induced cephalalgia

Abstract Aims To what extent Personal Protective Equipment (PPE) impacts integrated cardiopulmonary-cerebrovascular function has not been examined. The hypothesis tested was that PPE adversely influences pulmonary gas exchange, resulting in systemic hypercapnic-hypoxaemia and cerebral hyperperfusion-induced cephalalgia. Methods Eight male Higher Surgical Trainees (aged 33 ± 2y) participated in a repeated measures crossover study, completing two-hour laparoscopic simulation tasks, on two separate occasions (separate days), once in standard operating attire, and once in full PPE (including FFP3 mask). Results Following two hours of simulation, full PPE (compared with standard operating attire) was associated with increased FICO2 (7.9% (±0.8%) vs. 7.1% (±1.2%); p = 0.025), decreased FIO2 (16.0% (±0.4%) vs. 16.6% (±0.5%); p = 0.011), and decreased peripheral O2 saturation (95% (± 1%) vs. 98% (±1%); p = 0.001). Headaches were reported by three participants in PPE (Chi2 3.692, p = 0.055), and was associated with increased Middle Cerebral Artery flow velocity; 82 (±4) cm/s, compared with 63 (±9) cm/s in the remaining five participants (p = 0.008). Skin temperature increased by 1.3 °C during simulation in PPE (p = 0.001), with an equal mean insensible fluid loss of 300ml under both conditions (p = 0.049). Conclusions Collectively, these findings highlight the integrated cardiopulmonary-cerebrovascular complications associated with PPE-induced impairment in pulmonary gas exchange. Protective countermeasures should be designed to prevent risk to healthcare staff and patients alike.