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Hypoxaemia is a typical feature of the coronavirus disease 2019 (COVID-19). The rapid rise in the number of patients requiring oxygen therapy during the pandemic may cause a sharp increase in oxygen demands and potential threats of supply disruption, particularly in developing countries1 or nursing homes. Moreover, the use of elevated oxygen flows via nasal cannula raises concerns about exhaled air dispersion distance and the potential risk of generating aerosols. 2–6

The Double-Trunk Mask (DTM)(image and description in supplement) is a patent-free handmade system which, when placed over nasal cannula, increases the PaO2 by 50% in patients with acute res piratory failure without clinical impact on PaCO2. 7 From another perspective, the DTM may reduce the oxygen flow required to correct hypoxaemia which, in addition to reducing side-effects of prolonged dry oxygen administration, 8–10 could …