Apnoeic Oxygenation by Nasal Cannula During Airway Management in Children Undergoing General Anaesthesia.

NCT ID: NCT03271827

Last Updated: 2017-09-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-31

Study Completion Date

2016-07-31

Brief Summary

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Airway management is a core clinical skill in anaesthesia. Pre-oxygenation prior to induction of anaesthesia is standard practice to prevent desaturation. Apnoeic oxygenation in adults is effective and prolongs the time to desaturation. The effectiveness of apnoeic oxygenation in the adult is well document, however evidence in the paediatric is lacking. Therefore, the aim of this study was to investigate the effectiveness of apnoeic oxygenation during airway management in children.

This was a pilot randomised controlled trial. Patients were randomised to either receive apnoeic oxygenation or standard care during the induction of anaesthesia. The primary outcome was the duration of safe apnoea, defined as a composite of the time to first event, either time for SpO2 to drop to 92% or time to successfully secure the airway, and the lowest SpO2 observed during airway management. Secondary outcomes were number of patients whose SpO2 dropped below 95% and number of patients whose SpO2 dropped below 92%.

Detailed Description

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Conditions

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Apnoeic Oxygenation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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Apnoeic oxygenation group

Standard airway management + 3 L/min of oxygen by nasal cannula

Group Type EXPERIMENTAL

Apnoeic oxygenation

Intervention Type DEVICE

3 L/min of oxygen by nasal cannula during as apnoeic oxygenation during airway management.

Standard care group

Standard airway management

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Apnoeic oxygenation

3 L/min of oxygen by nasal cannula during as apnoeic oxygenation during airway management.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients were included who were scheduled for elective surgery under general anaesthesia.
* Age: one eight years old.
* ASA I and II only.
* Patients with normal cardiorespiratory function.

Exclusion Criteria

* Children undergoing dental surgeries in which nasal intubation is needed.
* Patients who suffered from quick drops in oxygen saturation more rapidly than healthy children due to different reasons such as: respiratory and pulmonary diseases, active or recent upper respiratory tract infection, syndromes with cardiopulmonary pathologies, cardiac anomalies, anaemia, depressed respiratory effort, ventilation/perfusion imbalance, Obstructive Sleep Apnoea (OSA), and airway obstruction.
* Patients reported with nasal obstruction.
* Patients with grades of laryngoscopic view (Cormack Lahane) greater than II, which indicates upper airway obstruction.
Minimum Eligible Age

1 Year

Maximum Eligible Age

8 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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King Abdullah International Medical Research Center

OTHER

Sponsor Role collaborator

Cardiff University

OTHER

Sponsor Role collaborator

University of Birmingham

OTHER

Sponsor Role lead

Responsible Party

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Lafi Olayan

Research fellow

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lafi Olayan, MSc

Role: PRINCIPAL_INVESTIGATOR

King Abdullah International Research Center (KAIMRC)

References

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Weingart SD, Levitan RM. Preoxygenation and prevention of desaturation during emergency airway management. Ann Emerg Med. 2012 Mar;59(3):165-75.e1. doi: 10.1016/j.annemergmed.2011.10.002. Epub 2011 Nov 3.

Reference Type BACKGROUND
PMID: 22050948 (View on PubMed)

Baraka AS, Taha SK, Siddik-Sayyid SM, Kanazi GE, El-Khatib MF, Dagher CM, Chehade JM, Abdallah FW, Hajj RE. Supplementation of pre-oxygenation in morbidly obese patients using nasopharyngeal oxygen insufflation. Anaesthesia. 2007 Aug;62(8):769-73. doi: 10.1111/j.1365-2044.2007.05104.x.

Reference Type BACKGROUND
PMID: 17635423 (View on PubMed)

Ramachandran SK, Cosnowski A, Shanks A, Turner CR. Apneic oxygenation during prolonged laryngoscopy in obese patients: a randomized, controlled trial of nasal oxygen administration. J Clin Anesth. 2010 May;22(3):164-8. doi: 10.1016/j.jclinane.2009.05.006.

Reference Type BACKGROUND
PMID: 20400000 (View on PubMed)

Wimalasena Y, Burns B, Reid C, Ware S, Habig K. Apneic oxygenation was associated with decreased desaturation rates during rapid sequence intubation by an Australian helicopter emergency medicine service. Ann Emerg Med. 2015 Apr;65(4):371-6. doi: 10.1016/j.annemergmed.2014.11.014. Epub 2014 Dec 20.

Reference Type BACKGROUND
PMID: 25536868 (View on PubMed)

Taha SK, Siddik-Sayyid SM, El-Khatib MF, Dagher CM, Hakki MA, Baraka AS. Nasopharyngeal oxygen insufflation following pre-oxygenation using the four deep breath technique. Anaesthesia. 2006 May;61(5):427-30. doi: 10.1111/j.1365-2044.2006.04610.x.

Reference Type BACKGROUND
PMID: 16674614 (View on PubMed)

Hardman JG, Wills JS, Aitkenhead AR. Factors determining the onset and course of hypoxemia during apnea: an investigation using physiological modelling. Anesth Analg. 2000 Mar;90(3):619-24. doi: 10.1097/00000539-200003000-00022.

Reference Type BACKGROUND
PMID: 10702447 (View on PubMed)

Hardman JG, Wills JS. The development of hypoxaemia during apnoea in children: a computational modelling investigation. Br J Anaesth. 2006 Oct;97(4):564-70. doi: 10.1093/bja/ael178. Epub 2006 Jul 27.

Reference Type BACKGROUND
PMID: 16873387 (View on PubMed)

Olayan L, Alatassi A, Patel J, Milton S. Apnoeic oxygenation by nasal cannula during airway management in children undergoing general anaesthesia: a pilot randomised controlled trial. Perioper Med (Lond). 2018 Feb 21;7:3. doi: 10.1186/s13741-018-0083-x. eCollection 2018.

Reference Type DERIVED
PMID: 29484172 (View on PubMed)

Other Identifiers

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SP15/134

Identifier Type: -

Identifier Source: org_study_id

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