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Effect of High-Flow Nasal Oxygen on Laryngoscopic View

4. maj 2026 opdateret af: Michal Kalina, Masarykova Nemocnice v Usti nad Labem, Krajska Zdravotni a.s.

Effect of Different Flows Using High-Flow Nasal Oxygen (HFNO) on Laryngoscopic View Quality During Videolaryngoscopy

This prospective, multicenter observational study aims to evaluate the effect of different flow rates of high-flow nasal oxygen (HFNO) on the quality of the laryngoscopic view during videolaryngoscopy in adult patients undergoing general anesthesia. Each patient will serve as their own control, with repeated measurements obtained at three different HFNO flow settings (0, 40, and 60 L/min). The study will assess objective and subjective parameters of glottic visualization using standardized scoring systems.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Anaesthetic management Anaesthesia induction and airway management will be standardized as far as clinically feasible. Standard monitoring will be applied according to institutional practice. Preoxygenation will be performed using high-flow nasal oxygen (HFNO). General anaesthesia will be induced using standard intravenous agents, followed by administration of neuromuscular blockade to facilitate laryngoscopy. Mask ventilation will be performed as clinically indicated.

Videolaryngoscopy will be performed using a standardized device and blade type whenever possible. All procedures will be performed by anesthesiologists experienced in videolaryngoscopy.

Study procedure

After induction of anaesthesia and achievement of adequate conditions for laryngoscopy, videolaryngoscopy will be performed. During a single laryngoscopic sequence, images of the laryngeal view will be obtained under three predefined HFNO flow conditions:

  • 0 L/min
  • 40 L/min
  • 60 L/min At each flow level, once a stable laryngeal view will be achieved, a still image will be captured using the videolaryngoscope recording system. The laryngoscope position will be maintained as stable as possible during acquisition of all three images. No attempt at tracheal intubation will be made during image acquisition.

After completion of the image capture protocol, tracheal intubation will be performed according to standard clinical practice.

All images will be anonymized and stored for subsequent offline analysis. Image assessment Captured images will be evaluated offline by an independent anesthesiologist blinded to HFNO flow rates and patient identity. Where applicable, evaluation will be performed by more than one assessor to allow assessment of inter-rater agreement.

Each image will be assessed using predefined objective and subjective measures (Percentage of Glottic Opening, Likert scale).

Undersøgelsestype

Observationel

Tilmelding (Anslået)

150

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

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult patients undergoing elective surgical procedures requiring endotracheal intubation under general anesthesia.

Beskrivelse

Inclusion Criteria:

  • Age ≥18 years
  • Scheduled for endotracheal intubation under general anesthesia
  • Use of videolaryngoscopy

Exclusion Criteria:

  • Anticipated difficult airway
  • Emergency intubation
  • Contraindications to HFNO
  • Inability to obtain adequate video recording

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Group HFNO
Adult patients with HFNO support for airway management
Enhed: HFNO flow 0
Different flows will be applied to patients undergoing general anaesthesia during airway management. In this arm flow will be 0 l/min. During these flows images will be captured using videolaryngoscope.
Enhed: HFNO flow 40
Different flows will be applied to patients undergoing general anaesthesia during airway management. In this arm flow will 40 l/min. During these flows images will be captured using videolaryngoscope.
Enhed: HFNO 60
Different flows will be applied to patients undergoing general anaesthesia during airway management. In this arm flow will 60 l/min. During these flows images will be captured using videolaryngoscope.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Quality of view
Tidsramme: From induction of general anesthesia to completion of orotracheal intubation (not longer than 10 minutes).
Percentage of glottic opening (POGO score) assessed from recorded videolaryngoscopic images.
From induction of general anesthesia to completion of orotracheal intubation (not longer than 10 minutes).

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Cormack-Lehane classification
Tidsramme: From induction of general anesthesia to completion of orotracheal intubation (not longer than 10 minutes).
Ordinal grading of glottic view using Cormack- Lehane classification.
From induction of general anesthesia to completion of orotracheal intubation (not longer than 10 minutes).
Subjective image quality (Likert scale)
Tidsramme: From induction of general anesthesia to completion of orotracheal intubation (not longer than 10 minutes).
Subjective assessment of laryngoscopic image quality rated on a 5-point Likert scale (1 = very poor, 5 = excellent) by independent evaluators blinded to HFNO flow conditions
From induction of general anesthesia to completion of orotracheal intubation (not longer than 10 minutes).

Samarbejdspartnere og efterforskere

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

Sponsor

Masarykova Nemocnice v Usti nad Labem, Krajska Zdravotni a.s.

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 (Anslået)

1. september 2026

Primær færdiggørelse (Anslået)

1. september 2027

Studieafslutning (Anslået)

1. december 2027

Datoer for studieregistrering

Først indsendt

4. maj 2026

Først indsendt, der opfyldte QC-kriterier

4. maj 2026

Først opslået (Faktiske)

8. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • HFNORCT

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Kliniske forsøg med Svær luftvej

Kliniske forsøg med HFNO flow 0

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