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Enhancing Oxygen Therapy and Preserving Oxygen Resources with the Double-Trunk Mask: Literature Review

Frédéric DuprezDepartment of ICU-URICE, Epicura Hospital, Hornu, BelgiumRida Cheikh YoussefDepartment of ICU-URICE, Epicura Hospital, Hornu, BelgiumJoseph AntounDepartment of Internal Medicine, Epicura Hospital, Hornu, BelgiumFrancios WaroquierTactical Medical Training Cell (TacMed), Centre of Medical Expertise, Belgian Defense, Neder over Hembeek, BelgiumF. Van TrimpontTactical Medical Training Cell (TacMed), Centre of Medical Expertise, Belgian Defense, Neder over Hembeek, BelgiumJean Baptiste WateletTactical Medical Training Cell (TacMed), Centre of Medical Expertise, Belgian Defense, Neder over Hembeek, Belgium
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Abstract

BACKGROUND: The prehospital availability of oxygen resources appears to be a critical limitation in military medicine. The fraction of inspired oxygen (FIO2) provided to patients is frequently lower than their pathophysiological needs. This deficit is due to the difficult mobilization of oxygen reserves and the volatile tactical pressure. Although several oxygen delivery devices are on the market, few effectively achieve optimal FIO2 levels. The double-trunk mask (DTM) represents a revolutionary solution that significantly improves the efficiency of oxygen delivery while conserving oxygen. The DTM is derived from a conventional aerosol mask. It includes two 22mm corrugated tubes secured in the side openings of the mask, each approximately 15 to 20cm in length in adults. METHODS: Following PICO screening, 15 eligible articles (prehospital, real-life settings, published 1990-2023 in English, Dutch, or French) indicated DTM's mechanisms of operation and efficacy. RESULTS: DTM significantly improves oxygen delivery while minimizing oxygen loss and improving pulmonary diffusion rates. The increase in PaCO2 is minimal despite the increase in material dead space. CONCLUSIONS: This device proves invaluable when oxygen supplies are limited, such as during pandemics or war. Its use maximizes administered FIO2 while minimizing oxygen consumption, optimizing patient care in resource-limited environments.

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