Page 27 - JSOM Summer 2025

TABLE 1 Studies Involving the Double-Trunk Mask (DTM)
First author (year) Study type Comparison Materials and methods Results
Farias (1991) 19 Prospective NRM vs. tusk mask • Low flow rate FIO with tusk mask greater than NRM
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(trunks 10cm) • N=5
• Healthy subjects
Hnatiuk (1998) 20 Prospective NRM vs. tusk mask • Low flow rate NRM
(corrugated tubing • n=16 • PaO : 290mmHg
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10cm) • Healthy subjects, mean age 30.4 y Tusk mask
• O flow rate: 15LPM • PaO : 330mmHg
2 2
• Low flow rate NRM
• n=7 • PaO : 293mmHg
2
• Mean age 68.1 y; pulmonary Tusk mask
interstitial disease • PaO : 378mmHg
2
• O flow rate: 15LPM
2
Bodur (2001) 13 Prospective NC vs. DTM • Low flow rate NC
randomized (trunks 38cm) • N=55 • PaO : 68mmHg
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crossover • Intensive care patients • PaCO : 41mmHg
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• O flow rate: 3.58LPM DTM
2
• PaO : 152mmHg
2
• PaCO : 45mmHg
2
Duprez (2021) 28 Prospective NC vs. DTM • Low flow rate NC
randomized (corrugated tubing • N=15 • PaO : 60mmHg
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crossover 15cm) • Mean age 69 y • PaCO : 39mmHg
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• Intensive care patients DTM
• O flow rate: 5LPM • PaO : 90mmHg
2 2
• PaCO : 42mmHg
2
Duprez (2022) 10 Prospective NRM vs. DTM • Low flow rate NRM
randomized (corrugated tubing • N=22 • PaO : 70mmHg
2
crossover 15cm) • Age 64, emergency care patients • PaCO : 33mmHg
2
(30 min) (COVID-19) DTM
• O flow rate: 10 and 15LPM • PaO : 85mmHg
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• PaCO : 35mmHg
2
Duprez (2022) 6 Bench study Comparison between • O flow rate: N=82 DTM delivers highest FIO , followed by NRM,
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different oxygen devices: • 10–15LPM then simple O face mask, and lastly NC.
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NC, simple O face • Inspiratory flow rate: 22–45LPM
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mask, NRM, DTM
Poncin (2020) 17 Prospective Assessment of the level • Low flow rate Using a DTM instead of NC allows the oxygen flow
randomized of oxygen economy • N=12 to be reduced from 5 to 1.5LPM while maintaining
crossover achieved between DTM • O flow rate: 5LPM the same level of oxygenation (PaO ). In this case,
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and NC the PaCO level does not change clinically
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Thajunnisa (2022) 31 Prospective Comparison: NRM and • Low flow rate Classical O mask
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randomized DTM • N=20 • PaO : 186mmHg
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crossover • Aged 18–70 y • PaCO : 33mmHg
2
• O flow rate: 10LPM DTM
2
• PaO : 368mmHg
2
• PaCO : 33mmHg
2
Poncin (2022) 16 Prospective COVID-19 patients; • Low flow rate PaO between NC and surgical mask increases
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randomized comparison between • N=24 from 20mmHg, and 40mmHg between surgical
crossover surgical mask over NC • O flow rate: 4.7LPM mask over NC and DTM over NC
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and DTM over NC Note: On average, the PaCO increased 2.4mmHg
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with the DTM.
Duprez (2001) 11 Prospective Comparison: NRM and • Low flow rate NRM
randomized DTM • N=40 • PaO : 171mmHg
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crossover • Intensive care patient • PaCO : 39mmHg
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• O flow rate 8LPM DTM
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• PaO : 278mmHg
2
• PaCO : 41mmHg
2
Comparison: NC and • Low flow rate CN
DTM: O flow rate: • N=40 • PaO : 89mmHg
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2
3LPM • Intensive care patients • PaCO : 41mmHg
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DTM
• PaO : 154mmHg
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• PaCO : 43mmHg
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Zellag (2021) 18 Prospective Intensive care patients; • Low flow rate For the same O flow, compared to NC, on
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randomized comparison: NC and • N=100 average, DTM increases SpO by 4%.
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crossover DTM • Mean age 67 y
• O flow rate: 6LPM
2
Duprez (2019) 29 Prospective Mean ROX index 6.3; HFNC HFNC
randomized intensive care patients; • N=15 • PaO : 63mmHg
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crossover comparison: HFNC and • Mean age 67 y • PaCO : 32mmHg
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HFNC+DTM FIO • Gas flow rate: 51LPM HFNC+DTM
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• PaO : 88mmHg
2
• PaCO : 35mmHg
2
Duprez (2022) 32 Bench study FIO administered via HFNC When inspiration flow rate increases, the difference
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the upper airways and • Flow: 40–60LPM between programmed and measured FIO increases
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the effect of DTM on the • FIO : 60%/80%/100% in the upper airways. In this case, DTM can
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actual FIO delivered. decrease this difference.
2
FIO = fraction of inspired oxygen; HFNC = high-flow nasal cannula; LPM = liters per minute; NC = nasal cannula; NRM = non-rebreathing mask; PaO = partial
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2
pressure of oxygen, arterial; PaCO = partial pressure of carbon dioxide, arterial; SpO = oxygen saturation as measured by pulse oximetry.
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Double-Trunk Mask for Efficient Oxygen Delivery | 25