Factors Determining Oxygen Wash in During Pre-oxygenation
Factors Determining End-tidal O2 Concentration in During Pre-oxygenation
調査の概要
状態
条件
詳細な説明
Before induction of general anaesthesia pre-oxygenation is a recommended procedure to enhance the time available for solving a problem with the airway or intubation during induction. This can be accomplished by letting the patient breath normal tidal volumes with 100% oxygen for 3 to 5 minutes during pre-oxygenation. If there is airway closure during tidal volume breathing, pre-oxygenation needs longer time to achieve a maximum effect. Airway closure increases with advanced age and a few earlier studies has also shown a correlation between older age and longer time for the rise in the end-tidal O2 concentration during pre-oxygenation.
Pre-oxygenation is a strongly recommended safety procedure before starting anaesthesia but has at least one major side affect: it is the main reason for the development of atelectasis in the lungs during anaesthesia. Atelectasis impairs oxygenation during anaesthesia and probably increase the risk for postoperative pulmonary complications.
Postoperative complications are more common with advanced age and it is important to understand the mechanisms and risk factors involved.
In this study, the investigators hypothesise that the PaO2 as measured before the start of pre-oxygenation, with the patient breathing air, is a better predictor than age for estimating the time necessary for achieving the goal of pre-oxygenation. If this assumption is correct it might have implication for how pre-oxygenation should be adjusted with advancing age.
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Västmanland
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Köping、Västmanland、スウェーデン、73130
- Köping County Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Patients scheduled for general anaesthesia in American Society of Anesthesiology (ASA) physical status classification grade I-III.
- Body mass index over 18.5 and less than 30 kg/m2
- Peripheral oxygen saturation 92% or more on air.
Exclusion Criteria:
- ASA IV.
- Patients with active smoking and former smokers with a history of smoking more than 6 pack-years.
- Chronic obstructive lung disease.
- Bloodgas with PaO2 ≤ 8 kilopascal (kPa) or PaCO2 ≥ 6.5 kPa.
- Continuous positive airway pressure treatment at night.
- Heart failure or angina pectoris.
- Hemoglobin value less than 100 g/L.
- Pregnancy.
- Any neuromuscular or neurologic illness reducing ventilatory capacity.
- Any endocrine disease influencing basic metabolic demand.
- Not possible to achieve a tight mask seal.
- Patient unable to follow instructions.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 観測モデル：コホート
- 時間の展望：見込みのある
コホートと介入
グループ/コホート |
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Age group 40-49
30 patients will be stratified to this age group.
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Age group 50-59
30 patients will be stratified to this age group.
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Age group 60-69
30 patients will be stratified to this age group.
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Age group 70-79
30 patients will be stratified to this age group.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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PaO2 breathing air before start of pre-oxygenation and the rise in end-tidal O2 during pre-oxygenation.
時間枠：5 minutes.
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An arterial bloodgas with the patient in the supine position breathing air will be analysed with regards to PaO2 and correlated to the rise in end-tidal O2 concentration during pre-oxygenation.
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5 minutes.
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Age and the rise in end-tidal O2 during pre-oxygenation.
時間枠：5 minutes.
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Age will be correlated to the rise in end-tidal O2 during pre-oxygenation.
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5 minutes.
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協力者と研究者
スポンサー
捜査官
- 主任研究者：Lennart Edmark, Ph.D.、Region Västmanland
出版物と役立つリンク
一般刊行物
- Kang H, Park HJ, Baek SK, Choi J, Park SJ. Effects of preoxygenation with the three minutes tidal volume breathing technique in the elderly. Korean J Anesthesiol. 2010 Apr;58(4):369-73. doi: 10.4097/kjae.2010.58.4.369. Epub 2010 Apr 28.
- Sum Ping SJ, Makary LF, Van Hal MD. Factors influencing oxygen store during denitrogenation in the healthy patient. J Clin Anesth. 2009 May;21(3):183-9. doi: 10.1016/j.jclinane.2008.07.004.
- Milic-Emili J, Torchio R, D'Angelo E. Closing volume: a reappraisal (1967-2007). Eur J Appl Physiol. 2007 Apr;99(6):567-83. doi: 10.1007/s00421-006-0389-0. Epub 2007 Jan 20.
- Gambee AM, Hertzka RE, Fisher DM. Preoxygenation techniques: comparison of three minutes and four breaths. Anesth Analg. 1987 May;66(5):468-70. No abstract available.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- 20170517-184
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