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Postoperative Pulmonary Complications After Use of Supraglottic Airway Devices and Neuromuscular Blockade (SupAIR)

14 de setembro de 2026 atualizado por: Manfred Blobner, University Hospital Ulm

SupAIR is an international, multicenter, randomized controlled trial investigating whether airway management and neuromuscular blockade during general anesthesia influence postoperative pulmonary complications.

Approximately 6,800 adults undergoing elective non-cardiac surgery will be randomized to one of five treatment arms: tracheal intubation with moderate neuromuscular blockade, tracheal intubation with deep neuromuscular blockade, supraglottic airway with moderate neuromuscular blockade, supraglottic airway with deep neuromuscular blockade, or supraglottic airway without neuromuscular blockade.

The primary outcome is the occurrence of postoperative pulmonary complications during the hospital stay. Secondary outcomes include perioperative complications, surgical conditions, recovery, and functional health. Participants will be followed during hospitalization and again approximately six months after surgery.

Visão geral do estudo

Status

Ainda não está recrutando

Condições

Intervenção / Tratamento

Descrição detalhada

SupAIR is an international, multicenter, randomized, controlled, parallel-group clinical trial evaluating the effects of airway management and neuromuscular blockade (NMB) on postoperative pulmonary complications after general anesthesia.

A total of 6,800 adults undergoing elective non-cardiac surgery will be randomized to one of five treatment arms:

  1. Tracheal tube with moderate NMB
  2. Tracheal tube with deep NMB
  3. Supraglottic airway device with moderate NMB
  4. Supraglottic airway device with deep NMB
  5. Supraglottic airway device without NMB

The five treatment arms result from an initial allocation to tracheal tube with NMB, supraglottic airway device with NMB, or supraglottic airway device without NMB. Participants assigned to NMB are additionally randomized to moderate or deep neuromuscular blockade.

The study addresses two primary hypotheses. First, among participants receiving NMB, use of a supraglottic airway device is hypothesized to reduce postoperative pulmonary complications compared with tracheal intubation. Second, among participants managed with a supraglottic airway device, the use of NMB is hypothesized not to increase postoperative pulmonary complications compared with no NMB. Finally, among participants receiving NMB depth of neuromuscular blockade will be used as secondary exposure.

The randomized intervention determines airway management and the use and depth of neuromuscular blockade. Quantitative neuromuscular monitoring is used in participants receiving NMB, and recovery from neuromuscular blockade is managed according to applicable clinical guidelines. All other aspects of perioperative anesthetic management are performed according to local clinical practice.

The primary outcome is the occurrence of at least one postoperative pulmonary complication from postoperative day 1 until hospital discharge or postoperative day 28, whichever occurs first. The composite includes respiratory failure, suspected pulmonary infection, pulmonary infiltrates, atelectasis, aspiration pneumonitis, bronchospasm, and pulmonary oedema.

Postoperative outcomes are assessed by blinded study personnel during the hospital stay. Secondary outcomes include intraoperative and postoperative complications, respiratory events in the post-anesthesia care unit, surgical conditions, quality of recovery, functional health, length of stay, intensive care treatment, and mortality. Participants are additionally followed by telephone approximately six months after surgery.

An interim analysis is planned after approximately 1,000 participants to assess assumptions relevant to sample-size planning. Interim results will be reviewed by the independent Data and Safety Monitoring Board, and the total sample size may be adjusted in accordance with the prespecified analysis plan.

Tipo de estudo

Intervencional

Inscrição (Estimado)

6800

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Estude backup de contato

  • Nome: Clinical Research Physician
  • Número de telefone: +49 731 50054306

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

Adult patients (≥ 18 years) with an ASA physical status ≤ 3 scheduled for elective non-cardiac surgery under general anaesthesia whose airway can be secured via tracheal tube or SGA.

Exclusion Criteria:

Contraindications for using supraglottic devices, tracheal tube, or neuromuscular blocking agents (and reversal drugs); surgery in prone positioning; surgical procedures scheduled outside the operating room; ambulatory surgery; pregnancy; patients planned for consecutive anaesthetic/surgical procedures in the following 14 days or within the past 14 days.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Prevenção
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Dobro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Comparador Ativo: Tracheal Tube with moderate Neuromuscular Blockade (TT/moderate NMB)
General anesthesia with tracheal tube management and moderate neuromuscular blockade.
For the superiority hypothesis the placement of the supraglottic airway device compared to the endotracheal tube is investigated.
Deep or moderate NMB. Muscle relaxants are administered according to group allocation. Repetitive doses of half the ED95s are administered at Train-of-Four (TOF) count ≥ 2 in the moderate group and at post-tetanic count (PTC) ≥ 2 in the deep blockade group.
Experimental: Supraglottic Airway Device with deep Neuromuscular Blockade (SGA/deep NMB)
General anesthesia with supraglottic airway device management and deep neuromuscular blockade.
For the superiority hypothesis the placement of the supraglottic airway device compared to the endotracheal tube is investigated.
Deep or moderate NMB. Muscle relaxants are administered according to group allocation. Repetitive doses of half the ED95s are administered at Train-of-Four (TOF) count ≥ 2 in the moderate group and at post-tetanic count (PTC) ≥ 2 in the deep blockade group.
For the non-inferiority hypothesis the initiation of neuromuscular blockade in patients receiving a supraglottic airway is investigated.
Comparador Ativo: Supraglottic Airway Device without Neuromuscular Blockade (SGA/no NMB)
General anaesthesia with supraglottic airway device management without neuromuscular blockade.
For the non-inferiority hypothesis the initiation of neuromuscular blockade in patients receiving a supraglottic airway is investigated.
Comparador Ativo: Tracheal Tube with deep Neuromuscular Blockade (TT/deep NMB)
General anesthesia with tracheal tube management and deep neuromuscular blockade.
For the superiority hypothesis the placement of the supraglottic airway device compared to the endotracheal tube is investigated.
Deep or moderate NMB. Muscle relaxants are administered according to group allocation. Repetitive doses of half the ED95s are administered at Train-of-Four (TOF) count ≥ 2 in the moderate group and at post-tetanic count (PTC) ≥ 2 in the deep blockade group.
Experimental: Supraglottic Airway Device with moderate Neuromuscular Blockade (SGA/moderate NMB)
General anesthesia with supraglottic airway device management and moderate neuromuscular blockade.
For the superiority hypothesis the placement of the supraglottic airway device compared to the endotracheal tube is investigated.
Deep or moderate NMB. Muscle relaxants are administered according to group allocation. Repetitive doses of half the ED95s are administered at Train-of-Four (TOF) count ≥ 2 in the moderate group and at post-tetanic count (PTC) ≥ 2 in the deep blockade group.
For the non-inferiority hypothesis the initiation of neuromuscular blockade in patients receiving a supraglottic airway is investigated.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Occurrence of at least one postoperative pulmonary complication
Prazo: Postoperative day one until hospital discharge or postoperative day 28, whichever occurs earlier
The primary outcome is a composite endpoint of postoperative pulmonary complications. It is met if a participant experiences at least one predefined postoperative pulmonary complication and their severity is graded according to the Clavien-Dindo-Classification
Postoperative day one until hospital discharge or postoperative day 28, whichever occurs earlier

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Intraoperative complications
Prazo: During the surgery
The classification of intraoperative adverse events (ClassIntra), ranging from grade 0 to grade V. It is used to assess intraoperative anaesthesia- and surgery-related complications.
During the surgery
Critical respiratory events in the recovery room
Prazo: During post-anesthesia care before admission to the normal ward
The outcome is met if at least one predefined critical respiratory event occurs. Events include upper airway obstruction requiring intervention, hypoxaemia not responding to active interventions, signs of respiratory distress or impending ventilatory failure, inability to breathe deeply, symptoms of respiratory or upper-airway muscle weakness, suspected pulmonary aspiration, or reintubation.
During post-anesthesia care before admission to the normal ward
Any postoperative in-hospital complication
Prazo: Patients are visited on postoperative days 1, 3, 5, 8, 15 and on the day of discharge from hospital or day 28 (whatever occurs first) to document complications between the current and the last visit.
Postoperative complications are recorded during the hospital stay during predefined visits in accordance with the postoperative morbidity survey including pulmonary, infectious, renal, gastrointestinal, cardiovascular, neurological, hematological, wound and pain). If a complication occurs each complication is categorized according to the Clavien-Dindo classification.
Patients are visited on postoperative days 1, 3, 5, 8, 15 and on the day of discharge from hospital or day 28 (whatever occurs first) to document complications between the current and the last visit.
Surgical conditions
Prazo: During surgery, assessed every 15 minutes
Surgical conditions will be assessed in a single-blinded manner via the Leiden Surgical Rating Scale which ranges from 1 to 5, with 1 indicating extremely poor surgical conditions and 5 indicating optimal surgical conditions considering visibility, surgical space, muscle contractions, handling tactics and patient movement.
During surgery, assessed every 15 minutes
Quality of Recovery questionnaire
Prazo: On postoperative day 1, day of discharge or on day 28 whatever occurs first and on postoperative day 180
The Quality of Recovery 15 questionnaire will be assessed and consists of 15 items to determine subjective recovery after surgery on an 11-point Likert scale (0-10).
On postoperative day 1, day of discharge or on day 28 whatever occurs first and on postoperative day 180
Functional Health
Prazo: On the day of admission and 180 days after surgery
The WHODAS-2 (World Health Organization Disability Assessment Schedule 2.0) scale will be used to quantify the level of disability.
On the day of admission and 180 days after surgery
Further Outcomes
Prazo: Retrieved from Chart Review or at the 180 day follow-up
Length of hospital stay, length of intensive care unit stay and 180-day mortality.
Retrieved from Chart Review or at the 180 day follow-up

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Colaboradores

Investigadores

  • Investigador principal: Manfred Blobner, Professor M.D., Department of Anesthesiology and Intensive Care Medicine, Ulm University Hospital, Ulm, Germany

Publicações e links úteis

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Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

15 de outubro de 2026

Conclusão Primária (Estimado)

1 de setembro de 2029

Conclusão do estudo (Estimado)

1 de setembro de 2030

Datas de inscrição no estudo

Enviado pela primeira vez

14 de setembro de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

14 de setembro de 2026

Primeira postagem (Real)

18 de setembro de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

18 de setembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

14 de setembro de 2026

Última verificação

1 de setembro de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • 388/24

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

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