Face Masks and the Cardiorespiratory Response to Physical Activity in Health and Disease.
Face Masks and the Cardiorespiratory Response to Physical Activity in Health and Disease.
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DOI：
10.1513/annalsats.202008-990cme
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发表时间：
2021-03
影响因子：
8.3
通讯作者：
Stickland MK
中科院分区：
文献类型：
--
作者：
Hopkins SR;Dominelli PB;Davis CK;Guenette JA;Luks AM;Molgat-Seon Y;Sá RC;Sheel AW;Swenson ER;Stickland MK
为了最大限度地减少导致冠状病毒病（COVID-19）的新型冠状病毒严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）的传播，美国疾病控制和预防中心和世界卫生组织建议在公共场所佩戴口罩。有些人担心这些可能会影响心肺系统，增加呼吸功，改变肺部气体交换和增加呼吸困难，特别是在体力活动期间。这些问题主要来自于对旨在严重影响呼吸力学和气体交换的器械进行评价的研究。我们回顾了文献中的各种口罩和呼吸系统的影响，在体力活动中使用的数据从几个模型：布面罩和外科口罩，N95呼吸机，工业呼吸机，并施加高阻力或高死腔呼吸负荷。总体而言，现有数据表明，尽管呼吸困难可能会增加并改变活动的感知努力，但在体力活动期间面罩对呼吸功、血气和其他生理参数的影响很小，通常太小而无法检测，即使在非常剧烈的运动期间也是如此。目前没有证据支持戴口罩时运动的生理反应存在性别或年龄差异。虽然现有数据表明，在健康个体的体力活动中使用布或外科口罩的负面影响可以忽略不计，不太可能显著影响运动耐力，但对于一些患有严重心肺疾病的个体，任何增加的阻力和/或血气的微小变化都可能引起更多的呼吸困难，从而影响运动能力。
To minimize transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel coronavirus responsible for coronavirus disease (COVID-19), the U.S. Centers for Disease Control and Prevention and the World Health Organization recommend wearing face masks in public. Some have expressed concern that these may affect the cardiopulmonary system by increasing the work of breathing, altering pulmonary gas exchange and increasing dyspnea, especially during physical activity. These concerns have been derived largely from studies evaluating devices intentionally designed to severely affect respiratory mechanics and gas exchange. We review the literature on the effects of various face masks and respirators on the respiratory system during physical activity using data from several models: cloth face coverings and surgical masks, N95 respirators, industrial respirators, and applied highly resistive or high–dead space respiratory loads. Overall, the available data suggest that although dyspnea may be increased and alter perceived effort with activity, the effects on work of breathing, blood gases, and other physiological parameters imposed by face masks during physical activity are small, often too small to be detected, even during very heavy exercise. There is no current evidence to support sex-based or age-based differences in the physiological responses to exercise while wearing a face mask. Although the available data suggest that negative effects of using cloth or surgical face masks during physical activity in healthy individuals are negligible and unlikely to impact exercise tolerance significantly, for some individuals with severe cardiopulmonary disease, any added resistance and/or minor changes in blood gases may evoke considerably more dyspnea and, thus, affect exercise capacity.