Factors Determining Oxygen Wash in During Pre-oxygenation

September 29, 2021 updated by: Lennart Edmark, Region Västmanland

Factors Determining End-tidal O2 Concentration in During Pre-oxygenation

Earlier studies has shown a correlation between older age and longer time for the rise in the end-tidal O2 concentration during pre-oxygenation. In this study the investigators aim to analyse this correlation more closely and investigate if the arterial partial pressure of oxygen (PaO2) as measured before the start of pre-oxygenation, with the patient breathing air, is a better predictor than age for estimating the time necessary for achieving the goal of pre-oxygenation.

Study Overview

Status

Completed

Conditions

Detailed Description

Before induction of general anaesthesia pre-oxygenation is a recommended procedure to enhance the time available for solving a problem with the airway or intubation during induction. This can be accomplished by letting the patient breath normal tidal volumes with 100% oxygen for 3 to 5 minutes during pre-oxygenation. If there is airway closure during tidal volume breathing, pre-oxygenation needs longer time to achieve a maximum effect. Airway closure increases with advanced age and a few earlier studies has also shown a correlation between older age and longer time for the rise in the end-tidal O2 concentration during pre-oxygenation.

Pre-oxygenation is a strongly recommended safety procedure before starting anaesthesia but has at least one major side affect: it is the main reason for the development of atelectasis in the lungs during anaesthesia. Atelectasis impairs oxygenation during anaesthesia and probably increase the risk for postoperative pulmonary complications.

Postoperative complications are more common with advanced age and it is important to understand the mechanisms and risk factors involved.

In this study, the investigators hypothesise that the PaO2 as measured before the start of pre-oxygenation, with the patient breathing air, is a better predictor than age for estimating the time necessary for achieving the goal of pre-oxygenation. If this assumption is correct it might have implication for how pre-oxygenation should be adjusted with advancing age.

Study Type

Observational

Enrollment (Actual)

120

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Sweden
    • Västmanland
      • Köping, Västmanland, Sweden, 73130
        • Köping County Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

38 years to 77 years (Adult, Older Adult)

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Patients scheduled for elective surgery in general anaesthesia.

Description

Inclusion Criteria:

  • Patients scheduled for general anaesthesia in American Society of Anesthesiology (ASA) physical status classification grade I-III.
  • Body mass index over 18.5 and less than 30 kg/m2
  • Peripheral oxygen saturation 92% or more on air.

Exclusion Criteria:

  • ASA IV.
  • Patients with active smoking and former smokers with a history of smoking more than 6 pack-years.
  • Chronic obstructive lung disease.
  • Bloodgas with PaO2 ≤ 8 kilopascal (kPa) or PaCO2 ≥ 6.5 kPa.
  • Continuous positive airway pressure treatment at night.
  • Heart failure or angina pectoris.
  • Hemoglobin value less than 100 g/L.
  • Pregnancy.
  • Any neuromuscular or neurologic illness reducing ventilatory capacity.
  • Any endocrine disease influencing basic metabolic demand.
  • Not possible to achieve a tight mask seal.
  • Patient unable to follow instructions.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Age group 40-49
30 patients will be stratified to this age group.
Age group 50-59
30 patients will be stratified to this age group.
Age group 60-69
30 patients will be stratified to this age group.
Age group 70-79
30 patients will be stratified to this age group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
PaO2 breathing air before start of pre-oxygenation and the rise in end-tidal O2 during pre-oxygenation.
Time Frame: 5 minutes.
An arterial bloodgas with the patient in the supine position breathing air will be analysed with regards to PaO2 and correlated to the rise in end-tidal O2 concentration during pre-oxygenation.
5 minutes.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Age and the rise in end-tidal O2 during pre-oxygenation.
Time Frame: 5 minutes.
Age will be correlated to the rise in end-tidal O2 during pre-oxygenation.
5 minutes.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Region Västmanland

Investigators

  • Principal Investigator: Lennart Edmark, Ph.D., Region Västmanland

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 30, 2018

Primary Completion (Actual)

September 17, 2021

Study Completion (Actual)

September 29, 2021

Study Registration Dates

First Submitted

January 4, 2018

First Submitted That Met QC Criteria

January 4, 2018

First Posted (Actual)

January 10, 2018

Study Record Updates

Last Update Posted (Actual)

September 30, 2021

Last Update Submitted That Met QC Criteria

September 29, 2021

Last Verified

September 1, 2021

More Information

Terms related to this study

Other Study ID Numbers

  • 20170517-184

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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