Improvement of Laryngoscopic View by Bed-up-head-elevated Position During Tracheal Intubation in Paediatric Patients

NCT ID: NCT05885789

Last Updated: 2023-06-05

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

UNKNOWN

Total Enrollment

125 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-03-01

Study Completion Date

2024-05-31

Brief Summary

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The goal of this prospective observational study is to learn about improvement of laryngoscopic view by Bed-Up-Head-Elevated (BUHE) during tracheal intubation in paediatric patients. The main question it aims to answer is:

1\. Does BUHE position improve laryngoscopic view during paediatric intubation?

Participants age 3-12 year-old going for elective surgery under general anaesthesia requiring tracheal intubation will undergo laryngoscopic twice, first in sniffing position (SP) and second during BUHE position.

POGO score during each laryngoscope will be compared. Additionally, ease of handling of laryngoscope during each position will be assessed.

Detailed Description

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This is a prospective observational study comparing POGO score during tracheal intubation in SP and BUHE position in paediatric patients aged 3 to 12 years who will undergo elective surgery under general anaesthesia requiring tracheal intubation. The first POGO score will be obtained during SP followed by second POGO score during BUHE position and the difference in POGO score before and after BUHE position will be recorded to learn the improvement in POGO score during BUHE position.

The objective of this study is to learn the improvement of laryngeal view in tracheal intubation after BUHE position in paediatric patients of age 3 to 12 years. Investigators hypothesised that laryngeal view in tracheal intubation improves after BUHE position compared to sniffing position.

Conditions

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Paediatric Airway Management

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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Paediatric patients

Intubation in Bed-Up-Head-Elevated (BUHE) position

Intervention Type PROCEDURE

Comparing laryngoscopic view in paediatric patients during sniffing position and BUHE position

Interventions

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Intubation in Bed-Up-Head-Elevated (BUHE) position

Comparing laryngoscopic view in paediatric patients during sniffing position and BUHE position

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 3 to 12 years
* Elective surgery under general anaesthesia requiring tracheal intubation

Exclusion Criteria

* Parents' / Guardian's refusal
* Known case of difficult airway or airway malformation or airway obstruction
* Patients with respiratory or cardiovascular disease
* Patients requiring rapid sequence induction
* Recent Upper Respiratory Tract Infection (URTI) of 2 weeks
Minimum Eligible Age

3 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Malaya

OTHER

Sponsor Role lead

Responsible Party

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Kim Bao Zhen

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bao Zhen Dr. Kim, MD

Role: PRINCIPAL_INVESTIGATOR

University of Malaya Medical Center

Locations

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University of Malaya Medical Center

Kuala Lumpur, , Malaysia

Site Status RECRUITING

Countries

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Malaysia

Central Contacts

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Bao Zhen Dr. Kim, MD

Role: CONTACT

+6016-7978582

Facility Contacts

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Bao Zhen Dr. Kim

Role: primary

+603-79494422

References

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Karsli C. Managing the challenging pediatric airway: Continuing Professional Development. Can J Anaesth. 2015 Sep;62(9):1000-16. doi: 10.1007/s12630-015-0423-y. Epub 2015 Aug 5.

Reference Type BACKGROUND
PMID: 26243378 (View on PubMed)

Schmidt AR, Weiss M, Engelhardt T. The paediatric airway: basic principles and current developments. Eur J Anaesthesiol. 2014 Jun;31(6):293-9. doi: 10.1097/EJA.0000000000000023.

Reference Type BACKGROUND
PMID: 24247412 (View on PubMed)

Holm-Knudsen RJ, Rasmussen LS. Paediatric airway management: basic aspects. Acta Anaesthesiol Scand. 2009 Jan;53(1):1-9. doi: 10.1111/j.1399-6576.2008.01794.x.

Reference Type BACKGROUND
PMID: 19128325 (View on PubMed)

Vialet R, Nau A. Effect of head posture on pediatric oropharyngeal structures: implications for airway management in infants and children. Curr Opin Anaesthesiol. 2009 Jun;22(3):396-9. doi: 10.1097/aco.0b013e3283294cc7.

Reference Type BACKGROUND
PMID: 19434789 (View on PubMed)

Kim EH, Ji SH, Song IK, Lee JH, Kim JT, Kim HS. Simple method for obtaining the optimal laryngoscopic view in children: A prospective observational study. Am J Emerg Med. 2017 Jun;35(6):867-870. doi: 10.1016/j.ajem.2017.01.048. Epub 2017 Jan 24.

Reference Type BACKGROUND
PMID: 28139308 (View on PubMed)

Ahn JH, Kim D, Gil NS, Son YH, Seong BG, Jeong JS. Improvement of laryngoscopic view by hand-assisted elevation and caudad traction of the shoulder during tracheal intubation in pediatric patients. Sci Rep. 2019 Feb 4;9(1):1174. doi: 10.1038/s41598-018-37770-6.

Reference Type BACKGROUND
PMID: 30718623 (View on PubMed)

Lee BJ, Kang JM, Kim DO. Laryngeal exposure during laryngoscopy is better in the 25 degrees back-up position than in the supine position. Br J Anaesth. 2007 Oct;99(4):581-6. doi: 10.1093/bja/aem095. Epub 2007 Jul 4.

Reference Type BACKGROUND
PMID: 17611252 (View on PubMed)

Black AE, Flynn PE, Smith HL, Thomas ML, Wilkinson KA; Association of Pediatric Anaesthetists of Great Britain and Ireland. Development of a guideline for the management of the unanticipated difficult airway in pediatric practice. Paediatr Anaesth. 2015 Apr;25(4):346-62. doi: 10.1111/pan.12615. Epub 2015 Feb 16.

Reference Type BACKGROUND
PMID: 25684039 (View on PubMed)

Tsan SEH, Lim SM, Abidin MFZ, Ganesh S, Wang CY. Comparison of Macintosh Laryngoscopy in Bed-up-Head-Elevated Position With GlideScope Laryngoscopy: A Randomized, Controlled, Noninferiority Trial. Anesth Analg. 2020 Jul;131(1):210-219. doi: 10.1213/ANE.0000000000004349.

Reference Type RESULT
PMID: 31348051 (View on PubMed)

Other Identifiers

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BUHE in paediatric

Identifier Type: -

Identifier Source: org_study_id

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