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

11 de agosto de 2026 actualizado por: 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.

Descripción general del estudio

Estado

Aún no reclutando

Condiciones

Intervención / Tratamiento

Tipo de estudio

Intervencionista

Inscripción (Estimado)

2032

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

Copia de seguridad de contactos de estudio

Ubicaciones de estudio

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

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Niño

Acepta Voluntarios Saludables

No

Descripción

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

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Otro
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: PEEP + PSV
Induction with PEEP (5 cmH2O) and PSV (2-12 cmH2O)
Procedimiento: 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.
Otro: Induction in spontaneous breathing
Procedimiento: 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

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Number of respiratory adverse events among laryngospasm, bronchospasm, oxygen desaturation, airway obstruction and severe cough
Periodo de tiempo: 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

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Number of respiratory adverse events among laryngospasm, bronchospasm and oxygen desaturation < 90%.
Periodo de tiempo: 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
Periodo de tiempo: Day 0
Risk difference and risk ratio at T4
Day 0
Use of oropharyngeal cannula or need for manual ventilation for difficult ventilation.
Periodo de tiempo: Day 0
Risk difference and risk ratio at T4
Day 0
Number of attempts to control the airways
Periodo de tiempo: 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
Periodo de tiempo: 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)
Periodo de tiempo: 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

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Hospices Civils de Lyon

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

1 de septiembre de 2026

Finalización primaria (Estimado)

1 de septiembre de 2029

Finalización del estudio (Estimado)

1 de septiembre de 2029

Fechas de registro del estudio

Enviado por primera vez

6 de agosto de 2026

Primero enviado que cumplió con los criterios de control de calidad

11 de agosto de 2026

Publicado por primera vez (Actual)

17 de agosto de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

17 de agosto de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

11 de agosto de 2026

Última verificación

1 de agosto de 2026

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • 69HCL24_0926

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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