{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T21:01:32Z","timestamp":1773435692591,"version":"3.50.1"},"reference-count":10,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health","award":["RC 34\/18"],"award-info":[{"award-number":["RC 34\/18"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Recently, a new type of full-face snorkeling mask (FFSM), called \u201cEasy-breath\u201d masks, has become extremely popular both in adults and children due to their effective marketing and relative comfort. However, these masks are complex engineering systems that, in case of malfunctioning or if used by young children, may readily cause CO2 rebreathing, especially in young children. Case Presentation: We present three cases of children under six years of age admitted to the emergency department, with two of them due to non-fatal drowning incidents and one following a cardiac arrest induced by drowning. All incidents occurred during brief submersions while using full-face snorkeling masks. Conclusions: When inappropriately used by younger children, full-face snorkeling masks may have a mechanical dead space larger than tidal volume, with a significant increased risk of rebreathing of CO2 and consequent risk for hypercapnic hypoxia. The hypercapnia may cause dizziness and respiratory distress, while hypoxia may cause confusion. Both may lead to loss of consciousness, which could be a potential cause of drowning, particularly in younger children.<\/jats:p>","DOI":"10.3390\/children12091148","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T09:08:52Z","timestamp":1756458532000},"page":"1148","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Full-Face Snorkeling Masks Carry a Risk of Hypercapnia and Drowning in Younger Children: A Case Series"],"prefix":"10.3390","volume":"12","author":[{"given":"Laura","family":"Trapani","sequence":"first","affiliation":[{"name":"Clinical Department of Medical, Surgical and Health Science, University of Trieste, 34127, Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1554-3174","authenticated-orcid":false,"given":"Federico","family":"Poropat","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Cattaruzzi","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6343-846X","authenticated-orcid":false,"given":"Egidio","family":"Barbi","sequence":"additional","affiliation":[{"name":"Clinical Department of Medical, Surgical and Health Science, University of Trieste, 34127, Trieste, Italy"},{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8513-1963","authenticated-orcid":false,"given":"Chiara","family":"Zanchi","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1097\/PEC.0000000000002987","article-title":"Drowning in Children and Predictive Parameters: A 15-Year Multicenter Retrospective Analysis","volume":"39","author":"Peri","year":"2023","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_2","unstructured":"(2025, July 17). Epicentro ISS. Available online: https:\/\/www.epicentro.iss.it\/incidenti\/infanziaOms08."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"313","DOI":"10.28920\/dhm53.4.313-320","article-title":"Full-face snorkel masks increase the incidence of hypoxaemia and hypercapnia during simulated snorkeling compared to conventional snorkels","volume":"53","author":"Grundemann","year":"2023","journal-title":"Diving Hyperb. Med."},{"key":"ref_4","unstructured":"Cooper, G. (2020, October 19). What I Learned from My Wife\u2019s Death Snorkeling on the Big Island. Available online: https:\/\/www.civilbeat.org\/2019\/02\/what-i-learned-from-my-wifes-death-snorkeling-on-the-big-island\/."},{"key":"ref_5","unstructured":"CBS News (2020, October 10). Increasingly Popular Full-Face Snorkel Masks Raise Safety Concerns. Available online: https:\/\/www.cbsnews.com\/news\/hawaii-full-face-snorkel-mask-related-deaths\/."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"29","DOI":"10.22462\/01.02.2022.3","article-title":"Testing of full face snorkel masks to examine recreational snorkeler deaths","volume":"49","author":"Farrell","year":"2022","journal-title":"Undersea Hyperb. Med."},{"key":"ref_7","unstructured":"The Italian Data Protection Authority (2025, July 17). Authorisation no. 9\/2014\u2014General Authorization to Process Personal Data for Scientific Research Purposes, Available online: https:\/\/www.garanteprivacy.it\/web\/guest\/home\/docweb\/-\/docweb-display\/docweb\/3786078."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Profili, J., Dubois, E.L., Karakitsos, D., and Hof, L.A. (2021). Overview of the User Experience for Snorkeling Mask Designs during the COVID-19 Pandemic. Healthcare, 9, Erratum in Healthcare 2021, 9, 817. https:\/\/doi.org\/10.3390\/healthcare9070817.","DOI":"10.3390\/healthcare9070817"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Germonpre, P., Van Rompaey, D., and Balestra, C. (2020). Evaluation of Protection Level, Respiratory Safety, and Practical Aspects of Commercially Available Snorkel Masks as Personal Protection Devices Against Aerosolized Contaminants and SARS-CoV2. Int. J. Environ. Res. Public Health, 17.","DOI":"10.20944\/preprints202005.0368.v2"},{"key":"ref_10","unstructured":"(2025, July 17). Pediatric Average Volume Assured Pressure Support\u2014Frontiers. Available online: https:\/\/www.frontiersin.org\/journals\/pediatrics\/articles\/10.3389\/fped.2022.868625\/full."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/9\/1148\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:35:02Z","timestamp":1760034902000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/9\/1148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,29]]},"references-count":10,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["children12091148"],"URL":"https:\/\/doi.org\/10.3390\/children12091148","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,29]]}}}