Two Modalities of Ventilation on the Occurrence of Respiratory Complications During Inhalational Anaesthetic Induction in Children (PEDIAMOVE)

August 11, 2026 updated by: Hospices Civils de Lyon

Comparison of Two MOdalities of VEntilation on the Occurrence of Respiratory Complications During Inhalational Anaesthetic Induction in Children: a Multicentre Randomised Controlled Trial.

Induction of anesthesia by inhalation is the most common method of induction (70% in France) for young children admitted for non-emergency surgery. It has the advantage of not requiring an intravenous line.

Serious respiratory adverse events such as laryngospasm or bronchospasm remain common in young children during anesthesia induction (approximately 4%) and can reach up to 30% when mild respiratory adverse events (coughing, desaturation < 95%, airway obstruction) are included.

Traditionally, inhalation induction is performed under spontaneous ventilation using the anesthesia ventilator circuit. However, modern ventilators offer the option of applying positive end-expiratory pressure (PEEP) and pressure support ventilation (PSV). Several physiological studies suggest that the use of PEEP + PSV during anesthesia may help maintain airway patency, minute ventilation, and functional residual capacity (FRC).

Our hypothesis is that administering PEEP + PSV at the time of induction may reduce the risk of respiratory complications.

The primary objective is to demonstrate that induction of anesthesia using PEP + PSV, compared with induction of anesthesia under spontaneous ventilation, reduces the risk of adverse respiratory events in children requiring general anesthesia with planned inhalational induction.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

2032

Phase

  • Not Applicable

Contacts and Locations

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

Study Contact

Study Contact Backup

Study Locations

  • France
      • Lyon, France, 69677
      • Marseille, France, 13385
        • Hôpitaux Universitaires de Marseille Timone
        • Contact:
        • Principal Investigator:
          • Fabrice Michel, Dr
      • Montpellier, France, 34295
        • Centre hospitalier universitaire de Montpellier
        • Contact:
        • Principal Investigator:
          • Chrystelle SOLA, Dr
      • Nantes, France, 44000
        • CHU de Nantes
        • Contact:
        • Principal Investigator:
          • Jules Lecomte, Dr
      • Paris, France, 75019
        • Hopital Robert Debre
        • Contact:
        • Principal Investigator:
          • Souhayl DAHMANI, Dr
      • Paris, France, 75012
        • Hôpital Armand Trousseau
        • Contact:
        • Principal Investigator:
          • Mireille Nasr, Dr
      • Reims, France, 51092
        • Centre Hospitalier Universitaire de Reims
        • Contact:
        • Principal Investigator:
          • Delpine Michelet, Dr
      • Strasbourg, France, 67200
        • Hopital de Hautepierre
        • Contact:
        • Principal Investigator:
          • Claire BOPP, Dr
      • Toulouse, France, 31300
        • CHU Toulouse - Hôpitaux des enfants
        • Contact:
        • Principal Investigator:
          • Delhpine KERN, Dr

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

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Child between 3 months and 6 years old
  • Without significant comorbidity (ASA 1 or 2)
  • Admitted for elective or emergency/urgent surgery under general anesthesia
  • With induction of anaesthesia by inhalation by sevoflurane on the machine circuit
  • With airway control by intubation tube or supraglottic device
  • Consent of at least one parent or legal guardian

Exclusion Criteria:

  • Children with severe upper respiratory tract infection (severe moist cough, fever and lethargy, oxygen requirement) in the last 7 days requiring intravenous induction or postpone of the surgery
  • Thoracic surgery with selective control of intubation
  • Criteria for difficult intubation or known history of difficult intubation
  • Children with a contraindication to sevoflurane (ex: risk of malignant hyperthermia)
  • Children asking for intravenous induction or requiring rapid sequence induction
  • Children with significant cardiac disease (pulmonary hypertension, cyanotic heart disease,…)
  • Children not affiliated or beneficiary of a health insurance system
  • Children participating in other interventional research with an exclusion period still in progress at inclusion

Exclusion Criteria :

  • Failure of venous access after 30 min or more than 5 attempts
  • Parents' consent withdrawal

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

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: PEEP + PSV
Induction with PEEP (5 cmH2O) and PSV (2-12 cmH2O)
Procedure: Induction with PEEP (5 cmH2O) and PSV (2-12 cmH2O)

Sevoflurane will initially be at 6% (with a fresh gas flow between 2L/min and 10L/min) or increase progressively according to local habits, which can be reduced between 4 and 6% during the installation of the vascular access and increased again to 6% before the control of the airway. The FiO2 will be set at 80% and can be increased up to 100% in case of desaturation.

In the experimental group, the level of PEEP will be set at 5 cmH2O and inspiratory support between 2 and 12 cmH2O and adjusted by the anaesthetist in charge to optimize respiratory mechanics and obtain a physiological tidal volume of 8ml/kg.
Other: Induction in spontaneous breathing
Procedure: Induction in spontaneous breathing

Sevoflurane will initially be at 6% (with a fresh gas flow between 2L/min and 10L/min) or increase progressively according to local habits, which can be reduced between 4 and 6% during the installation of the vascular access and increased again to 6% before the control of the airway. The FiO2 will be set at 80% and can be increased up to 100% in case of desaturation.

In the control group, there is no PEEP

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of respiratory adverse events among laryngospasm, bronchospasm, oxygen desaturation, airway obstruction and severe cough
Time Frame: Day 0
  • Laryngospasm: complete or partial obstruction of the airway associated with rigidity of the abdominal and thoracic muscles measured by the physician in charge
  • Bronchospasm: increase in work of breathing, particularly in exhalation (signs of respiratory distress) with wheezing measured by the physician in charge
  • Oxygen desaturation: <95% more than 10 sec or < 90% measured by the physician in charge
  • Airway obstruction: airway obstruction with inspiratory noise and increased work of breathing or requiring manual ventilation measured by the physician in charge
  • Severe cough: coughing fit lasting more than 10 sec or requiring drug intervention (intravenous anaesthetic agents, lidocaine, neuromuscular blockade agents) measured by the physician in charge
Day 0

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of respiratory adverse events among laryngospasm, bronchospasm and oxygen desaturation < 90%.
Time Frame: Day 0
Risk difference and risk ratio at T4
Day 0
Number of respiratory adverse events among airway obstruction, desaturation < 95% for more than 10s and severe cough
Time Frame: Day 0
Risk difference and risk ratio at T4
Day 0
Use of oropharyngeal cannula or need for manual ventilation for difficult ventilation.
Time Frame: Day 0
Risk difference and risk ratio at T4
Day 0
Number of attempts to control the airways
Time Frame: Day 0

Attempts at tracheal intubation or laryngeal mask insertion, as reported by the physician in charge.

Risk difference and risk ratio at T4
Day 0
Number of gastric distension requiring evacuation
Time Frame: Day 0
Reported by the physician in charge. Risk difference and risk ratio at T4
Day 0
Pressure support (cmH2O) and tidal volumes (ml/Kg)
Time Frame: Day 0

Pressure support (cmH2O) set on the ventilator by the physician in charge (continuous variable) Tidal volumes measured on the ventilator by the physician in charge (continuous variable)

Relation between the pressure support and the tidal volume at each time T1 and T2 separately
Day 0

Collaborators and Investigators

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

Sponsor

Hospices Civils de Lyon

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 (Estimated)

September 1, 2026

Primary Completion (Estimated)

September 1, 2029

Study Completion (Estimated)

September 1, 2029

Study Registration Dates

First Submitted

August 6, 2026

First Submitted That Met QC Criteria

August 11, 2026

First Posted (Actual)

August 17, 2026

Study Record Updates

Last Update Posted (Actual)

August 17, 2026

Last Update Submitted That Met QC Criteria

August 11, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 69HCL24_0926

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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