Despite the growing importance of oxygen-delivery devices worldwide, there are only a few reports of physiological data on various oxygen masks in children. The possibility of carbon dioxide (CO2) rebreathing has been a prevalent concern with the use of oxygen-delivery devices. OxyMask KidTM (Southmedic Inc. Canada; hereafter OxyMask) is expected to reduce CO2 rebreathing even at low oxygen flow rates because of its structural features. Biological data using OxyMask in children have not been well investigated. Measured respiratory parameters of OxyMask with those of a simple oxygen mask in healthy children were compared. Ten subjects were enrolled, with a median age of 5.4 years. All subjects used both OxyMask and a simple oxygen mask. The fraction of inspiratory oxygen (FIO2), partial pressure of inspiratory CO2 (PICO2), and partial pressure of end-tidal CO2 were measured using a sidestream gas-sampling monitor in all subjects. The oxygen flow rate was set at 1, 3, 5, and 10 L/min. FIO2 levels were higher with OxyMask than those with the simple oxygen mask at 3 L/min of oxygen. PICO2 levels were significantly lower with OxyMask than those with the simple oxygen mask (1.5 mmHg vs. 3.7 mmHg at 1 L/min, P = 0.005; 1.0 mmHg vs. 2.7 mmHg at 3 L/min, P = 0.005, respectively), whereas PICO2 levels were higher at low oxygen flow rates with both masks.
Conclusion: Our results showed that higher FIO2 and less CO2 rebreathing were achieved with OxyMask than those with a simple oxygen mask at low flow rates of oxygen in healthy children.
|What is Known:|
• OxyMask is expected to reduce carbon dioxide rebreathing even at low oxygen flow rates because of its structural features.|
• Efficacy has been demonstrated in experimental models and adult data, but clinical data on the use of the OxyMask in children are limited.
What is New:
• Higher fraction of inspiratory oxygen and lesser carbon dioxide rebreathing were achieved with OxyMask than with a simple oxygen mask at low flow rates of oxygen in healthy children
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
- FIO2 :
Fraction of inspiratory oxygen
- PETCO2 :
Partial pressure of end-tidal carbon dioxide
- PICO2 :
Partial pressure of inspiratory carbon dioxide
Hamish G, Ayobami AB, Chizoba F, Owens W, Trevor D, Adegoke GF (2020) Oxygen therapy for children: a key tool in reducing deaths from pneumonia. Pediatr Pulmonol 55:S61–S64
de Caen AR, Berg MD, Chameides L, Gooden CK, Hickey RW, Scott HF, Sutton RM, Tijssen JA, Topjian A, van der Jagt ÉW, Schexnayder SM, Samson RA (2015) Part 12: Pediatric advanced life support: American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 132:S526–S542
Wang CH, Chang WT, Huang CH, Tsai MS, Yu PH, Wang AY, Chen NC, Chen WJ (2014) The effect of hyperoxia on survival following adult cardiac arrest: a systematic review and meta-analysis of observational studies. Resuscitation. 85:1142–1148
Jensen AG, Johnson A, Sandstedt S (1991) Rebreathing during oxygen treatment with face mask. The effect of oxygen flow rates on ventilation. Acta Anaesthesiol Scand 35:289–292
Paul JE, Hangan H, Hajgato J (2009) The OxyMask development and performance in healthy volunteers. Medical Devices 2:9–17
Lamb K, Piper D (2016) Southmedic OxyMask™ compared with the Hudson RCI® non-rebreather mask™: safety and performance comparison. Can J Respir Ther 52:13–15
Wagstaff TA, Soni N (2007) Performance of six types of oxygen delivery devices at varying respiratory rates. Anaesthesia 62:492–503
Tomoko Y, Kiyoshi M, Akira M, Mariko K, Kohji U, Tomoki K (2014) Effect of fit of non-rebreathing oxygen mask with a reservoir bag at various oxygen flow rates on inspiratory oxygen concentrations using a high-fidelity patient simulator. J Jpn Soc Intensive Care Med 21:607–613
Uygur P, Oktem S, Boran P, Tutar E, Tokuc G (2016) Low- versus high-flow oxygen delivery systems in children with lower respiratory infection. Pediatr Int 58:49–52
Ergul AB, Calıskan E, Samsa H, Gokcek I, Kaya A, Zararsiz GE, Torun YA (2018) Using a high-flow nasal cannula provides superior results to OxyMask delivery in moderate to severe bronchiolitis: a randomized controlled study. Eur J Pediatr 177:1299–1307
Coghill M, Ambalavanan N, Chatburn RL, Hibberd PL, Wright LL, Carlo WA (2011) Accuracy of a novel system for oxygen delivery to small children. Pediatrics 128:e382–e387
Beecroft JM, Hanly PJ (2006) Comparison of the OxyMask and venturi mask in the delivery of supplemental oxygen: pilot study in oxygen-dependent patients. Can Respir J 13:247–252
Availability of data and materials
The datasets used and/or analyzed during the current study are available from the corresponding author on request.
The study was conducted with the approval of the ethics committee of our hospital (ethics approval number rin2014-27).
Consent to participate
Written informed consent was obtained from all individual parents. All the methods were conducted following the relevant guidelines, regulations, and the Declaration of Helsinki.
Consent for publication
Written informed consent was obtained from all individual parents included in the study.
The authors declare no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Communicated by Peter de Winter
About this article
Cite this article
Ogiwara, S., Tamura, T., Sai, S. et al. Superiority of OxyMaskTM with less carbon dioxide rebreathing in children. Eur J Pediatr (2021). https://doi.org/10.1007/s00431-021-04157-1
- Oxygen-delivery device
- Oxygen therapy
- Diffuser mask
- Pediatric respiratory physiology