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High Fresh Gas Flow After Intubation

12. maj 2015 opdateret af: Erland Ostberg, Region Västmanland

High Fresh Gas Flow After Intubation - A Randomized Clinical Trial

Atelectasis is common during and after general anesthesia. Atelectasis develops early if preoxygenation with 100% oxygen is used and continuously used during induction until endotracheal intubation. The investigators hypothesize that a rapid anti-preoxygenation maneuver immediately after confirming a successful intubation, reduces the area of atelectasis as investigated by computed tomography compared to a standard procedure.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

24

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Sverige
    • Västmanland
      • Köping, Västmanland, Sverige, 731 30
        • Landstinget Västmanland

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

40 år til 75 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Healthy patients, American Society of Anesthesiology (ASA) I-II
  • Patients scheduled for orthopaedic day case surgery in general anaesthesia

Exclusion Criteria:

  • ASA class III or higher
  • Body Mass Index (BMI) 30 or higher
  • Arterial oxygen saturation (SpO2) <94% breathing air
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Ischemic heart disease
  • Haemoglobin <100g/L
  • Known or anticipated difficult airway and/or intubation
  • Active smokers and ex-smokers with a history of more than 6 pack years
  • Need for interscalene or supraclavicular regional anaesthesia with risk of phrenic nerve paralysis

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Control group, conventional ventilatory settings

Handling of the airway during induction and intubation is performed in a conventional manner.

Initial ventilatory settings are also done in a conventional manner.
Procedure: Control group, conventional ventilatory settings

Handling of the airway during induction and intubation is performed in a conventional manner.

Initial ventilatory settings are also done in a conventional manner. As soon as correct position of the endotracheal tube is confirmed, controlled ventilation is started with a tidal volume of 7 mL/kg ideal body weight, PEEP 6 or 8 cm H2O (8 if BMI >25) and a respiratory frequency of 10. The fresh gas flow is set to 1 Liter per minute with an oxygen mixture of 40%, aiming for an inspired FiO2 of 30-35%.

Unless the patient´s SpO2 falls below 90%, the FiO2 remains unchanged throughout the procedure.
Aktiv komparator: High fresh gas flow, high minute ventilation

Handling of the airway during induction and intubation is performed in a conventional manner.

Immediately after confirming a successful intubation the effect of preoxygenation is eliminated with an anti-preoxygenation maneuver.
Procedure: High fresh gas flow, high minute ventilation

Handling of the airway during induction and intubation is performed in a conventional manner.

Immediately after confirming a successful intubation, the effect of preoxygenation is eliminated with a fresh gas flow of 10 L/min of air, delivered with volume controlled ventilation consisting of tidal volumes of approximately 15 ml/kg ideal body weight, a positive expiratory pressure of 10 cm H20 and a respiratory frequency of 10. As soon as the end tidal O2 reaches 25%, the ventilator settings are adjusted to normal values (same as in the control group), i.e. tidal volume 7 mL/kg ideal body weight, PEEP 6 or 8 cm H2O (8 if BMI >25). The mixture of oxygen in the fresh gas is increased to 40% and the fresh gas flow is set to 1 Liter per minute, aiming for an inspired FiO2 of 30-35%.

Unless the patient´s SpO2 falls below 90%, the FiO2 remains unchanged throughout the procedure.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Atelectasis
Tidsramme: Within 1-2 hours, just before emergence from anesthesia
The area of atelectasis in the lungs is assessed by computed tomography (CT) 10 mm above the dome of the right diaphragm and expressed in cm2 and as % of the total lung area in the particular scan.
Within 1-2 hours, just before emergence from anesthesia

Sekundære resultatmål

Resultatmål
Tidsramme
Arterial blood gases
Tidsramme: Within 2-3 hours perioperatively
Within 2-3 hours perioperatively

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Region Västmanland

Efterforskere

  • Studiestol: Mats Enlund, MD, PhD, Landstinget i Värmland

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. september 2014

Primær færdiggørelse (Faktiske)

1. maj 2015

Studieafslutning (Faktiske)

1. maj 2015

Datoer for studieregistrering

Først indsendt

1. august 2014

Først indsendt, der opfyldte QC-kriterier

12. august 2014

Først opslået (Skøn)

13. august 2014

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

13. maj 2015

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

12. maj 2015

Sidst verificeret

1. maj 2015

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • Dnr 2012/335

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Control group, conventional ventilatory settings

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Sponsorer og samarbejdspartnere

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Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner