ArticleJournal of the neurological sciences2020
Powered Air Purifying Respirator (PAPR) restores the N95 face mask induced cerebral hemodynamic alterations among Healthcare Workers during COVID-19 Outbreak.
Article in Journal of the neurological sciences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Physio-metabolic and clinical consequences of wearing face masks-Systematic review with meta-analysis and comprehensive evaluation.Frontiers in public health · 2023Pooled it
- Personal protective equipment-associated headaches in health care workers during COVID-19: A systematic review and meta-analysis.Frontiers in public health · 2022Pooled it
- Trial
- Carbon dioxide rises beyond acceptable safety levels in children under nose and mouth covering: Results of an experimental measurement study in healthy children.Environmental research · 2022Trial
- Comparison of Effects of N95 Respirators and Surgical Masks to Physiological and Psychological Health among Healthcare Workers: A Randomized Controlled Trial.International journal of environmental research and public health · 2021Trial
- Factors Associated With Craniocervical and Otological Symptoms in Healthcare Workers During Covid-19 Pandemic: A Cross-Sectional Study.Journal of oral rehabilitation · 2026Article
- Risks and benefits of face masks in children.Frontiers in pediatrics · 2026Review
- Primary Headache Attributed to External Compression or Traction to the Head: A Narrative Review.Brain and behavior · 2025Review
- The influence of N95 and surgical masks on carbon dioxide levels: A comprehensive systematic review and meta-analysis.Heliyon · 2024Article
- Physiological effects of N95 respirators on rescuers during cardiopulmonary resuscitation.Heliyon · 2023Article
- Human thermal physiological response of wearing personal protective equipment: An educational building semi-open space experimental investigation.The Science of the total environment · 2023Article
- Article
- Headache caused by the use of personal protective equipment in healthcare workers during the COVID-19 pandemic period.Heliyon · 2023Article
- The impact of the COVID-19 pandemic era on children with primary headache: a questionnaire survey study and literature review.Frontiers in pediatrics · 2023Article
- Thermophysiological and Perceptual Responses of Amateur Healthcare Workers: Impacts of Ambient Condition, Inner-Garment Insulation and Personal Cooling Strategy.International journal of environmental research and public health · 2022Article
- Article
- Headache related to personal protective equipment in healthcare workers during COVID-19 pandemic in Mexico: baseline and 6-month follow-up.International archives of occupational and environmental health · 2022Article
- Physical problems of prolonged use of personal protective equipment during the COVID-19 pandemic: A scoping review.Nursing forum · 2022Article
- External nasal dilator decreases N95 respirator-related respiratory effort and symptoms in gastrointestinal endoscopy unit staff.Endoscopy international open · 2022Article
- Examination of the Effects of 4-Hour Nonvalved Filtering Facepiece Respirator Use on Blood Gas Values of Health Care Professionals: A Before and After Study.Journal of emergency nursing · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimCOVID-19 pandemic has resulted in an unprecedented increased usage of Personal protective equipment (PPE) by healthcare-workers. PPE usage causes headache in majority of users. We evaluated changes in cerebral hemodynamics among healthcare-workers using PPE.
methodsFrontline healthcare-workers donning PPE at our tertiary center were included. Demographics, co-morbidities and blood-pressure were recorded. Transcranial Doppler (TCD) monitoring of middle cerebral artery was performed with 2-MHz probe. Mean flow velocity (MFV) and pulsatility index (PI) were recorded at baseline, after donning N95 respirator-mask, and after donning powered air-purifying respirator (PAPR), when indicated. End-tidal carbon-dioxide (ET-CO2) pressure was recorded for participants donning PAPR in addition to the N95 respirator-mask.
resultsA total of 154 healthcare-workers (mean age 29 ± 12 years, 67% women) were included. Migraine was the commonest co-morbidity in 38 (25%) individuals while 123 (80%) developed de-novo headache due to N95 mask. Donning of N95 respirator-mask resulted in significant increase in MFV (4.4 ± 10.4 cm/s, p < 0.001) and decrease in PI (0.13 ± 0.12; p < 0.001) while ET-CO2 increased by 3.1 ± 1.2 mmHg (p < 0.001). TCD monitoring in 24 (16%) participants donning PAPR and N95 respirator mask together showed normalization of PI, accompanied by normalization of ET-CO2 values within 5-min. Combined use of N95 respirator-mask and PAPR was more comfortable as compared to N95 respirator-mask alone.
conclusionUse of N95 respirator-mask results in significant alterations in cerebral hemodynamics. However, these effects are mitigated by the use of additional PAPR. We recommend the use of PAPR together with the N95 mask for healthcare-workers doing longer duties in the hospital wards.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.