- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT07767851
Two Modalities of Ventilation on the Occurrence of Respiratory Complications During Inhalational Anaesthetic Induction in Children (PEDIAMOVE)
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.
Panoramica dello studio
Stato
Tipo di studio
Iscrizione (Stimato)
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
- Nome: Florent Baudin, Pr
- Numero di telefono: +00334 72 12 97 35
- Email: florent.baudin@chu-lyon.fr
Backup dei contatti dello studio
- Nome: Clarisse Saunier
- Numero di telefono: +0033427856264
- Email: clarisse.saunier@chu-lyon.fr
Luoghi di studio
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Lyon, Francia, 69677
- Hopital Femme Mere Enfant
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Contatto:
- Florent Baudin, Pr
- Numero di telefono: +00334 72 12 97 35
- Email: florent.baudin@chu-lyon.fr
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Contatto:
- Eloise Cercueil, Dr
- Numero di telefono: +00334 27 85 52 48
- Email: Eloise.cercueil@chu-lyon.fr
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Investigatore principale:
- Eloise Cercueil, Dr
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Marseille, Francia, 13385
- Hôpitaux Universitaires de Marseille Timone
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Contatto:
- Fabrice Michel, Dr
- Numero di telefono: +334.91.96.47.58
- Email: fabrice.michel@ap-hm.fr
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Investigatore principale:
- Fabrice Michel, Dr
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Montpellier, Francia, 34295
- Centre hospitalier universitaire de Montpellier
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Contatto:
- Chrystelle SOLA, Dr
- Numero di telefono: (+33)4 67 33 24 48
- Email: c-sola@chu-montpellier.fr
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Investigatore principale:
- Chrystelle SOLA, Dr
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Nantes, Francia, 44000
- CHU de Nantes
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Contatto:
- Jules LECOMTE, Dr
- Numero di telefono: (+33) 2 40 08 32 50
- Email: jules.lecomte@chu-nantes.fr
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Investigatore principale:
- Jules Lecomte, Dr
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Paris, Francia, 75019
- Hopital Robert Debre
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Contatto:
- Souhayl DAHMANI, Dr
- Numero di telefono: (+33)1 40 03 22 21
- Email: souhayl.dahmani@rdb.aphp.fr
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Investigatore principale:
- Souhayl DAHMANI, Dr
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Paris, Francia, 75012
- Hôpital Armand Trousseau
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Contatto:
- Mireille Nasr, Dr
- Numero di telefono: +00331 44 73 51 20
- Email: mireille.nasr@aphp.fr
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Investigatore principale:
- Mireille Nasr, Dr
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Reims, Francia, 51092
- Centre Hospitalier Universitaire de Reims
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Contatto:
- Delphine Michelet, Dr
- Numero di telefono: (+33)3 26 83 25 37
- Email: dmichelet@chu-reims.fr
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Investigatore principale:
- Delpine Michelet, Dr
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Strasbourg, Francia, 67200
- Hôpital de Hautepierre
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Contatto:
- Claire BOPP, Dr
- Numero di telefono: (+33) 3 88 12 61 38
- Email: claire.bopp@chru-strasbourg.fr
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Investigatore principale:
- Claire BOPP, Dr
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Toulouse, Francia, 31300
- CHU Toulouse - Hôpitaux des enfants
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Contatto:
- Delhpine KERN, Dr
- Numero di telefono: (+33)5 34 55 84 23
- Email: kern.d@chu-toulouse.fr
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Investigatore principale:
- Delhpine KERN, Dr
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Bambino
Accetta volontari sani
Descrizione
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
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Altro
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
|
Sperimentale: PEEP + PSV
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. |
|
Altro: 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 |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Number of respiratory adverse events among laryngospasm, bronchospasm, oxygen desaturation, airway obstruction and severe cough
Lasso di tempo: Day 0
|
|
Day 0
|
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Number of respiratory adverse events among laryngospasm, bronchospasm and oxygen desaturation < 90%.
Lasso di tempo: 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
Lasso di tempo: Day 0
|
Risk difference and risk ratio at T4
|
Day 0
|
|
Use of oropharyngeal cannula or need for manual ventilation for difficult ventilation.
Lasso di tempo: Day 0
|
Risk difference and risk ratio at T4
|
Day 0
|
|
Number of attempts to control the airways
Lasso di tempo: 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
Lasso di tempo: 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)
Lasso di tempo: 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
|
Collaboratori e investigatori
Sponsor
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Completamento primario (Stimato)
Completamento dello studio (Stimato)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Processi patologici
- Malattie delle vie respiratorie
- Disturbi respiratori
- Condizioni patologiche, segni e sintomi
- Aspirazione respiratoria
- Terapie
- Gestione delle vie aeree
- Terapia respiratoria
- Respirazione, artificiale
- Terapia di modalità combinata
- Terapia neoadiuvante
- Respirazione a pressione positiva
Altri numeri di identificazione dello studio
- 69HCL24_0926
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