Diego Dulanto Zabala’s research while affiliated with Hospital de Basurto and other places

Sumary: We compared electrocardiograms (ECGs) findings with one year difference between each other with and without use of face mask at the moment to be tested. The first ECG was done one year before without face mask, and the second ECG with a mask one year later after 3 months of mandatory use for epidemiological COVID-19 pandemic justifications in healthy youth elite athletes. Results: Regarding heart rate variability (HRV), an increase in RMSSD was recorded when the test was performed with a mask (M): 108.5 ± 90 ms vs. No mask (NM): 72.9 ± 54.2 ms (p

Introduction Due to the mandatory use of a mask in the context of the Covid-19 pandemic, we set out to evaluate the physiological impact of hypoxia and hypercapnia generated by different masks at rest. Methods Thirty-two competitive adolescent athletes (40% female) were evaluated. Room air and intra-mask measurements were taken at rest while sitting in a chair. A spirometric study was performed and the intra-mask concentration of O2 and CO2 was evaluated, comparing 3 situations: a) Home (H): mask that the subject was wearing from home. b) Surgical (S): surgical mask. c) KN95 mask (KN95). Results The ambient air in the laboratory was: O2: 20.9% and CO2: 544 ± 67 ppm (0.05%); Intra-mask O2: H: 17.8 ± 0.72 %; S: 17.08 ± 0.62 %; KN95: 16.8 ± 0.56 %; (H vs S: ns; H vs NK95: p <0.001; S vs KN95: p <0.002). Intra-mask CO2: H: 1.81 ± 0.52 %; S 1.92 ± 0.35 %; KN95: 2.07 ± 0.36%; (H vs S: ns; H vs NK95: p <0.001; S vs KN95: p <0.012). CO2 levels with KN95 were lower in men 1.97 ± 0.37 % vs 2.2 ± 0.29 % than in women (p<0.04), with a significant correlation between gender and weight (r: 0.98, p: 0.01) and height (r: 0.78, p: 0.01). Conclusions The KN95 mask presented a lower concentration of O2, and a higher concentration of CO2 compared to the baseline situation with the surgical masks and those home-made. There is a difference in CO2 between the sexes when the KN95 mask was used, in relation to weight and height.

Introduction: Due to the mandatory use of a mask in the context of the COVID-19 pandemic, and the authorization to do outdoor sports in Catalonia, we set out to evaluate the physiological impact of the hypoxia and hypercapnia generated by the mask during aerobic exercise. Methods: 46 adolescent competitive athletes (35 women, 11 men) were evaluated. Measurements were taken of ambient air, at rest intra-mask, and during a stress test intra-mask. The concentration of O2 and CO2 intra-mask and the O2 Saturation were evaluated. Results: The O2 of ambient air in the laboratory: 20.9%; Basal intra-mask O2: 18.0 ± 0.7% and intra-mask O2 during exercise: 17.4 ± 0.6% (p <0.0001). The CO2 was: 0.05 ± 0.01% environmental; baseline intra-mask: 1.31 ± 0.5%, and during exercise intra-mask: 1.76 ± 0.6% (p <0.0001). Baseline O2 saturation with mask was 98.4 ± 0.6% and immediately after exercise was 97.1 ± 2.8% (p <0.03). During the exercise intra-mask, 30% of the young athletes exceeded 2% of CO2 and 22% breathed oxygen with a concentration lower than 17%. Conclusions: The use of masks generate hypercapnic hypoxia during exercise. One third of the subjects exceed the CO2 threshold of 2%.

Introduction: Due to the mandatory use of a mask, and the authorization to do outdoor sports in Catalonia, we try to assess the physiological impact of the hypercapnia hypoxia generated by the masks during aerobic sports practice. Methods: Eight subjects (2 women) were assessed at baseline with and without a mask, and then a 21-flex test was performed following the Ruffier protocol with a mask. Control of HR (heart rate), concentration of O2 and CO2 inside the mask and SatO2. The test was carried out in ambient air in squares in the city of Barcelona. Results: A decrease in O2 was recorded comparing the three conditions, baseline 20.9%, baseline mask 18.3%, post-exercise 17.8% (p <0.001). An increase in CO2 in the three preconditions (464, 14162, 17000 ppm; p <0.001). Basal saturation O2 was 97.6 ± 1.5% and post exercise 92.1 ± 4.12% (p 0.02). Conclusions: The use of masks in athletes causes hypoxic and hypercapnic breathing, being more evident in effort. The use of masks during a short exercise with an intensity around 6-8 METS, decreases O2 by 3.7% and increases the CO2 concentration by 20%.

Estudio de la adaptación fisiológica en personas respirando aire enrarecido en una sima.

Background There are very few studies on the pharmacodynamics of neuromuscular blockers in diabetic patients. Objective To analyze neuromuscular block reversal with sugammadex in type 2 diabetics compared with non-diabetic individuals, following rocuronium administration at usual doses. Patients and methods Prospective observational study. A total of 67 patients [33 diagnosed with type 2 diabetes (T2DM group) and 34 non-diabetics (control group)] were enrolled. Muscle relaxation was induced with rocuronium at usual doses (0.6 mg/kg plus maintenance boluses of 0.15 mg/kg), and neuromuscular block was monitored through the surgical procedure. At the end of the operation, upon return of the second response (T2) to the train of four (TOF), sugammadex was administered at a dose of 2 mg/kg. Primary endpoint: time from sugammadex administration to TOF ratio ≥0.9 (T2-TOF90) and TOF ratio ≥0.7 (T2-TOF70). Secondary endpoints: onset time, time to return of the first response (T1) to the TOF. Results No statistically significant differences (p=0.797) in reversal with sugammadex (T2-TOF90) were recorded between T2DM group and control group (162.73 versus 156.32 s). Likewise, there were no differences in the remaining pharmacodynamic variables analyzed (onset time, reappearance of T1 and T2-TOF70). Conclusion Sugammadex reversal at usual doses in diabetic patients shows no differences versus general population. This drug is therefore useful for preventing residual neuromuscular block in the diabetic population.

Introducción y objetivos: En el macizo del Garraf (Barcelona) las simas tienen una atmósfera con disminución de oxígeno y aumento de CO2 respecto a la normalidad. Para valorar el nivel de riesgo en la exploración de estas cavidades estudiamos a 19 espeleólogos (14 hombres y 5 mujeres) al realizar un ejercicio controlado, en una atmósfera hipercápnica, hipóxica y normobárica (15,2 ± 0,8% de O2 y 19.049 ± 299 ppmv de CO2). Métodos: El estudio se realizó en laboratorio mediante ergometría. Se realizaron 2 tests, uno en atmósfera normal (NN) y otro idéntico realizado en ambiente confinado (tienda de hipoxia), con aire enrarecido (HH). Se monitorizaron los siguientes parámetros: electrocardiograma, frecuencia cardíaca, saturación de oxígeno de la hemoglobina, lactato, glucemia capilar y presión arterial final. Resultados: Los voluntarios presentaron diferente sintomatología durante la prueba con aire enrarecido: sensación de calor (100%), mareo (47%), cefalea (3%), prurito ocular (21%), temblor en las manos (16%), extrasístoles (16,5%), respuesta hipertónica de la presión arterial (26%), taquicardia (158,5 ± 15,9 latidos/min en aire enrarecido frente a 148,7 ± 15,7 latidos/min en aire normal; p < 0,0002). Todos presentaron una disminución de la saturación de oxígeno (93,4 ± 3,4% en aire enrarecido frente a 97,7 ± 9,92% en aire normal; p < 0,00004). Discusión: Se observó una gran variabilidad individual en los síntomas y parámetros estudiados. En vista de los resultados, se recomienda no sobrepasar el umbral de 45.000 ppmv de CO2 en exploración espeleológica. Asimismo es conveniente una revisión médica de aptitud

Introduction and aims: The atmosphere in the abysses of the mountains of Garraf (Barcelona) have lower oxygen levels and higher CO2 concentrations with respect to normality. To evaluate the risk of speleological exploration in this area, we studied 19 cavers (14 men and 5 women) while performing controlled exercise in a hypercapnic, hypoxic and normobaric atmosphere (15.2 ± 0.8% of 299 O2 and 19,049 ± 299 ppmv of CO2). Methods: The study was performed in a laboratory through ergometry. Two identical tests were used: one in a standard atmosphere (NN) and another in a confined atmosphere (a hypoxic tent), with rarefied air (HH). The following parameters were monitored: electrocardiogram, heart rate, oxygen saturation of hemoglobin, lactate, capillary glycemia, and final blood pressure. Results: The volunteers had distinct symptoms during the test with rarefied air: heat sensation (100%), dizziness (47%), headache (3%), ocular pruritus (21%), hand tremor (16%), extrasystoles (16.5%), hypertonic blood pressure behavior (26%), tachycardia (158.5 ± 15.9 bpm in rarefied air versus 148.7 ± 15.7 bpm in normal air; p<0.0002). All participants showed reduced oxygen saturation (93.4 ± 3.4% in rarefied air versus 97.7 ± 9.92% in normal air; p<0.00004). Discussion: Wide individual variability was found in symptoms and the parameters studied. In view of the results of this study, we recommend that a threshold of 45,000 ppmv of CO 2 not be exceeded in speleological exploration. Likewise, fitness assessment should be performed in individuals planning to enter confined atmospheres, such as the caves and abysses of this mountain.

Introduction and aims: The atmosphere in the abysses of the mountains of Garraf (Barcelona) have lower oxygen levels and higher CO2 concentrations with respect to normality. To evaluate the risk of speleological exploration in this area, we studied 19 cavers (14 men and 5 women) while performing controlled exercise in a hypercapnic, hypoxic and normobaric atmosphere (15.2 ± 0.8% of 299 O2 and 19,049 ± 299 ppmv of CO2). Methods: The study was performed in a laboratory through ergometry. Two identical tests were used: one in a standard atmosphere (NN) and another in a confined atmosphere (a hypoxic tent), with rarefied air (HH). The following parameters were monitored: electrocardiogram, heart rate, oxygen saturation of hemoglobin, lactate, capillary glycemia, and final blood pressure. Results: The volunteers had distinct symptoms during the test with rarefied air: heat sensation (100%), dizziness (47%), headache (3%), ocular pruritus (21%), hand tremor (16%), extrasystoles (16.5%), hypertonic blood pressure behavior (26%), tachycardia (158.5 ± 15.9 bpm in rarefied air versus 148.7 ± 15.7 bpm in normal air; p<0.0002).All participants showed reduced oxygen saturation (93.4 ± 3.4% in rarefied air versus 97.7 ± 9.92% in normal air; p<0.00004). Discussion: Wide individual variability was found in symptoms and the parameters studied. In view of the results of this study, we recommend that a threshold of 45,000 ppmv of CO2 not be exceeded in speleological exploration. Likewise, fitness assessment should be performed in individuals planning to enter confined atmospheres, such as the caves and abysses of this mountain.