- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico 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.
Visão geral do estudo
Status
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Florent Baudin, Pr
- Número de telefone: +00334 72 12 97 35
- E-mail: florent.baudin@chu-lyon.fr
Estude backup de contato
- Nome: Clarisse Saunier
- Número de telefone: +0033427856264
- E-mail: clarisse.saunier@chu-lyon.fr
Locais de estudo
-
-
-
Lyon, França, 69677
- Hopital Femme Mere Enfant
-
Contato:
- Florent Baudin, Pr
- Número de telefone: +00334 72 12 97 35
- E-mail: florent.baudin@chu-lyon.fr
-
Contato:
- Eloise Cercueil, Dr
- Número de telefone: +00334 27 85 52 48
- E-mail: Eloise.cercueil@chu-lyon.fr
-
Investigador principal:
- Eloise Cercueil, Dr
-
Marseille, França, 13385
- Hôpitaux Universitaires de Marseille Timone
-
Contato:
- Fabrice Michel, Dr
- Número de telefone: +334.91.96.47.58
- E-mail: fabrice.michel@ap-hm.fr
-
Investigador principal:
- Fabrice Michel, Dr
-
Montpellier, França, 34295
- Centre hospitalier universitaire de Montpellier
-
Contato:
- Chrystelle SOLA, Dr
- Número de telefone: (+33)4 67 33 24 48
- E-mail: c-sola@chu-montpellier.fr
-
Investigador principal:
- Chrystelle SOLA, Dr
-
Nantes, França, 44000
- CHU de Nantes
-
Contato:
- Jules LECOMTE, Dr
- Número de telefone: (+33) 2 40 08 32 50
- E-mail: jules.lecomte@chu-nantes.fr
-
Investigador principal:
- Jules Lecomte, Dr
-
Paris, França, 75019
- Hopital Robert Debre
-
Contato:
- Souhayl DAHMANI, Dr
- Número de telefone: (+33)1 40 03 22 21
- E-mail: souhayl.dahmani@rdb.aphp.fr
-
Investigador principal:
- Souhayl DAHMANI, Dr
-
Paris, França, 75012
- Hôpital Armand Trousseau
-
Contato:
- Mireille Nasr, Dr
- Número de telefone: +00331 44 73 51 20
- E-mail: mireille.nasr@aphp.fr
-
Investigador principal:
- Mireille Nasr, Dr
-
Reims, França, 51092
- Centre Hospitalier Universitaire de Reims
-
Contato:
- Delphine Michelet, Dr
- Número de telefone: (+33)3 26 83 25 37
- E-mail: dmichelet@chu-reims.fr
-
Investigador principal:
- Delpine Michelet, Dr
-
Strasbourg, França, 67200
- Hôpital de Hautepierre
-
Contato:
- Claire BOPP, Dr
- Número de telefone: (+33) 3 88 12 61 38
- E-mail: claire.bopp@chru-strasbourg.fr
-
Investigador principal:
- Claire BOPP, Dr
-
Toulouse, França, 31300
- CHU Toulouse - Hôpitaux des enfants
-
Contato:
- Delhpine KERN, Dr
- Número de telefone: (+33)5 34 55 84 23
- E-mail: kern.d@chu-toulouse.fr
-
Investigador principal:
- Delhpine KERN, Dr
-
-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Filho
Aceita Voluntários Saudáveis
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Outro
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: 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. |
|
Outro: 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 |
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Number of respiratory adverse events among laryngospasm, bronchospasm, oxygen desaturation, airway obstruction and severe cough
Prazo: Day 0
|
|
Day 0
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Number of respiratory adverse events among laryngospasm, bronchospasm and oxygen desaturation < 90%.
Prazo: 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
Prazo: Day 0
|
Risk difference and risk ratio at T4
|
Day 0
|
|
Use of oropharyngeal cannula or need for manual ventilation for difficult ventilation.
Prazo: Day 0
|
Risk difference and risk ratio at T4
|
Day 0
|
|
Number of attempts to control the airways
Prazo: 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
Prazo: 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)
Prazo: 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
Patrocinador
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Processos Patológicos
- Doenças Respiratórias
- Distúrbios Respiratórios
- Condições Patológicas, Sinais e Sintomas
- Aspiração Respiratória
- Terapêutica
- Gerenciamento das vias aéreas
- Terapia respiratória
- Respiração, artificial
- Terapia de modalidade combinada
- Terapia neoadjuvante
- Respiração de pressão positiva
Outros números de identificação do estudo
- 69HCL24_0926
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .