The low-flow mask oxygen could be a better treatment for emergency psychogenic hyperventilation syndromes: a double-blind, randomized controlled trial

Abstract

Objectives To compare the effect of low-flow mask oxygenation (LFMO) with breathing training (BT) for psychogenic hyperventilation syndrome (PHVS), providing more options and evidence for clinical treatment. Methods A double-blind, randomized controlled trial (Registered number: ChiCTR2300072044, June 1, 2023) was conducted in a tertiary hospital from 5 June 2023 to 25 June 2023. Participants were recruited and randomly assigned to the LFMO or BT groups. All participants were guided and presented PHVS, then the LFMO group inhaled 3L/minute oxygen with the oxygen mask, and the BT group took the breath training with 20 breath rate/minute. The length of the recovery from PHVS and the comfort/tolerance score were collected as the primary outcome. and the PH, lactate, K+, Ca2+, PO₂, and PCo₂ was collected as the secondary outcome. Results Forty-four participants completed the study and were included for analysis (21 for the LFMO group and 23 for the BT group), mainly female (75%, n = 33). After a period of fast breathing, all participants diagnosed with PHVS by the 1st ABG test (Pco₂: 27.40 ± 3.11; 28.80 ± 1.87) and Nijmegen Questionnaire(23.47 ± 0.66; 23.38 ± 0.58), and all participants recovered from PHVS after interventions. However, the LFMO group showed significant advantages in both the length of recovery (22.41 ± 3.36, p < 0.000) and comfort/tolerance (5.85 ± 1.23, p = 0.011), while no significant difference was detected among secondary outcomes. Conclusion Compared to traditional breath training, low-flow mask oxygenation could be a better treatment for PHVS, especially in emergency departments, with more comfort and faster recovery.