Esophageal Manometry During Recovery From Endotracheal Intubation
- An intact pharyngoesophageal reflex is essential to protect the upper airway from aspiration of either mouth contents or regurgitated gastric refluxate. This reflex is essential at protecting the airway in all patients.
- In patients, while under medication to tolerate endotracheal intubation, it is postulated that an identifiable upper esophageal sphincter and esophageal peristalsis are not present.
- With the cessation of anesthetics, accompanied by the reversal of nerve block, normal pharyngoesophageal peristaltic activity correlates with awakening the patient from anesthesia. This would be identified by the performance of esophageal manometry.
- A return of normal verbally stimulated pharyngoesophageal swallowing sequence accurately identifies a safe time to remove endotracheal tubes and/or reverse anesthesia. This verbally stimulated swallowing sequence correlated precisely with the return of objective pharyngoesophageal function.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: John P Cello, MD
- Telefonnummer: 628-206-4767
- E-mail: john.cello@ucsf.edu
Undersøgelse Kontakt Backup
- Navn: Alex Rodas, MA
- Telefonnummer: 628-206-4746
- E-mail: alex.rodas@ucsf.edu
Studiesteder
-
-
California
-
San Francisco, California, Forenede Stater, 94143
- University of California, San Francisco
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Patients between 18 and 70 years of age (ASA I or II).
- Already scheduled for endotracheal tube extubation.
- Willing and able to give informed consent in either English or Spanish.
Exclusion Criteria:
- Pregnant, breastfeeding, or unwilling to practice birth control during participation in the study.
- Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.
- Patients not meeting entry criteria above.
- Refusal to give informed consent.
- Coagulopathy (INR > 2 and/or platelet count < 100,000.
- White Blood Cell count < 5,000/mm3
- Arrhythmia
- Serum creatinine > 2 mg/dl
- Prior known or suspected nasal obstruction.
- Known or suspected Zenker's diverticulum of esophagus, esophageal stricture, head/neck radiation therapy, hereditary telangiectasis, esophageal varices, cirrhosis.
- Anticoagulant usage such as heparin or Plavix
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Støttende pleje
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Andet: Manometry Device
At 10 minutes prior to anticipated removal of the endotracheal tube, pass the routine manometry catheter per naris to 30 cms.
|
The use of esophageal manometry device during removal of endotracheal tube by anesthesia
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
The Basal Pressures of patients during High-Resolution Motility/Manometry (HRM):
Tidsramme: The change in Basal Pressures will be recorded at the end of procedure.
|
High-resolution manometry (HRM) determination of return of cricopharyngeal function - Basal Pressures: Upper esophageal sphincter (mmHg) - normal (34-104) |
The change in Basal Pressures will be recorded at the end of procedure.
|
|
The Residual Pressures of patients during High-Resolution Motility/Manometry (HRM):
Tidsramme: The change in Residual Pressures will be recorded at the end of procedure.
|
- Residual Pressures: Upper esophageal sphincter (mmHg) - normal (<12.0)
|
The change in Residual Pressures will be recorded at the end of procedure.
|
|
The Wave Duration of patients during High-Resolution Motility/Manometry (HRM):
Tidsramme: The change in Wave Duration will be recorded at the end of procedure.
|
- Motility: Wave Duration (seconds) - normal (2.7-5.4)
|
The change in Wave Duration will be recorded at the end of procedure.
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Percentage of patients agreeing to study versus refusing study.
Tidsramme: During enrollment
|
Percentage/number of patients/next of kin accepting protocol
|
During enrollment
|
|
Number of patients completing study.
Tidsramme: At the completion of procedure
|
Percentage/number of patients completing esophageal motility/manometry study.
|
At the completion of procedure
|
|
Duration of HRM
Tidsramme: The HRM study of the cricopharyngeus will be measured for the 5 minute time period just before planned endotracheal extubation to the time during extubation and for the 5 minute period just after endotracheal extubation.
|
Duration (minutes) of motility/manometry research study during withdrawal of endotracheal intubation.
|
The HRM study of the cricopharyngeus will be measured for the 5 minute time period just before planned endotracheal extubation to the time during extubation and for the 5 minute period just after endotracheal extubation.
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Stanley J Rogers, MD, University of California, San Francisco
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 22-36634
Plan for individuelle deltagerdata (IPD)
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Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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