Preoxygenation With High-flow Nasal Oxygen in Adult Trauma Patients During Rapid Sequence Induction Anaesthesia (PRIOR-Trauma)
Preoxygenation With High-flow Nasal Oxygen in Comparison to Standard Face Mask in Adult Trauma Patients During Rapid Sequence Induction Anesthesia- a Prospective, Non-randomized, Before-and-after Study
Previous studies investigating apnoea oxygenation has shown that delivering oxygen via a high flow can maintain adequate oxygen saturation levels in a patient for over 30 minutes.
It has recently been demonstrated, in several studies, that High Flow Nasal Oxygen (HFNO) used during preoxygenation in patients undergoing emergency surgery is at least equally effective as preoxygenation with standard tight fitting mask. Data from these recent studies investigating arterial oxygen saturation levels during rapid sequence induction anaesthesia have not been able to detect any difference between the two methods. The mean apnea time among the patients in the previous studies have been relatively short.
Patients suffering traumatic injuries could be more prone to desaturate during prolonged apnea due to being hemodynamic unstable or suffering injuries to the respiratory tract.
Based on the above, the aim is now to conduct a trial where trauma patients are preoxygenated with high flow nasal oxygen before anaesthetised with rapid sequence induction (RSI) technique. The trial is set to be a before-and-after study. During approximately 6 to 9 months data will be registered from trauma patients undergoing emergency anaesthesia where preoxygenation is performed according to standard rutin, with traditional facemask. During the coming six to nine months trauma patients undergoing emergency anaesthesia will be preoxygenated with high flow nasal oxygen. Data will be registered and compared to the data collected from the patients preoxygenated with facemark.
The general purpose of this project is to compare the preoxygenation technique based on HFNO with traditional preoxygenation with a tight fitting mask, with the main focus being oxygen saturation levels, during rapid sequence induction (RSI) intubation in trauma patients in need of immediate anaesthesia.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Inscripción (Anticipado)
Contactos y Ubicaciones
Estudio Contacto
- Nombre: Malin Jonsson Fagerlund
- Número de teléfono: 0707691405
- Correo electrónico: malin.jonsson-fagerlund@sll.se
Ubicaciones de estudio
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Stockholm, Suecia, SE-17176
- Reclutamiento
- Karolinska University Hospital Solna
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Contacto:
- Malin Jonsson Fagerlund
- Número de teléfono: +46707691405
- Correo electrónico: malin.jonsson.fagerlund@ki.se
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Método de muestreo
Población de estudio
Descripción
Inclusion Criteria:
- 1 Adult, ≥18 years old
- 2 Level 1 trauma with patients in need of emergency anaesthesia before leaving the trauma unit (trauma room or nearby operating theatre).
Exclusion Criteria:
- 1 Patients with or with risk of skull or facial injuries where application of nasal cannula is decided to be avoided by the trauma team.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
Cohortes e Intervenciones
Grupo / Cohorte |
Intervención / Tratamiento |
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Tight fitting facemask
Preoxygenation with tight facemask, 100% oxygen.
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Preoxygenation with tight facemask, 10 L/min, 100% oxygen.
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High flow nasal oxygen
Preoxygenation with high flow nasal oxygen, 100% oxygen
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Preoxygenation with high flow nasal oxygen, 40-70 L/min, 100% oxygen.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Number of patients with a peripheral oxygen saturation (SpO2) below 93%
Periodo de tiempo: From start of anaesthesia until 1 minute after tracheal intubation.
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Compare the number of patients with a peripheral oxygen saturation (SpO2) below 93% from induction of anesthesia (when induction drug is administered) until one minute after intubation between the group preoxygenated using HFNO and the group preoxygenated with traditional tight-fitting mask.
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From start of anaesthesia until 1 minute after tracheal intubation.
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Lowest median SpO2.
Periodo de tiempo: From start of anaesthesia until 1 minute after tracheal intubation.
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Lowest median SpO2 during preoxygenation using HFNO compared to traditional preoxygenation from when first anesthetic drug is administered until 1 minute after intubation
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From start of anaesthesia until 1 minute after tracheal intubation.
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End tidal gas levels
Periodo de tiempo: At the first breath after tracheal intubation.
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Difference in levels of ETO2 and ETCO2 in the first breath after intubation with HFNO oxygenation compared to traditional pre-oxygenation.
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At the first breath after tracheal intubation.
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Time span from start of preoxygenation until intubation.
Periodo de tiempo: Could vary depending on patient and trauma, from a couple of minutes up to 20-30 minutes.
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Compare the time span from start of preoxygenation until intubation between the HFNO group and the group with traditional preoxygenation.
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Could vary depending on patient and trauma, from a couple of minutes up to 20-30 minutes.
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Time span from entering trauma room until intubation.
Periodo de tiempo: Could vary depending on patient and trauma, from a couple of minutes up to an hour.
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Time span from when the patient enters the trauma room until intubation in the HFNO group compared to the group with traditional preoxygenation.
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Could vary depending on patient and trauma, from a couple of minutes up to an hour.
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Difficulties with induction of anaesthesia
Periodo de tiempo: Could vary depending on patient and trauma, from a couple of minutes up to 20-30 minutes.
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Compare the perceived difficulties during induction of anaesthesia between the HFNO technique and traditional preoxygenation, for example tolerance to mask or nasal cannula
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Could vary depending on patient and trauma, from a couple of minutes up to 20-30 minutes.
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Frequency of complications
Periodo de tiempo: Could vary depending on patient and trauma, from a couple of minutes up to 20-30 minutes.
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Frequency of complications (aspiration, signs of intraabdominal/intracranial gas, difficulties intubating the trachea, hypotension) in the HFNO group compared to the group preoxygenated with traditional facemask.
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Could vary depending on patient and trauma, from a couple of minutes up to 20-30 minutes.
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Malin Jonsson Fagerlund, Karolinska University Hospital and Karolinska Institute
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Anticipado)
Finalización del estudio (Anticipado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- PRIOR-Trauma
Plan de datos de participantes individuales (IPD)
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Información sobre medicamentos y dispositivos, documentos del estudio
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