Functional Residual Capacity Under Apnoeic Oxygenation with Different Flow Rates in Children

Summary

During induction of general anaesthesia physiological breathing stops and needs to be artificially established with facemask ventilation, and finally tracheal intubation or placement of a supraglottic airway. During the airway management, when lungs are not or only poorly ventilated, there is a risk for atelectasis. These atelectasis can contribute to respiratory adverse events (e.g. pulmonary infection or respiratory insufficiency) during or after general anaesthesia. High-flow nasal oxygen (HFNO) is the administration of heated, humidified and blended air/oxygen mixture via a nasal cannula at rates ≥ 2 L/kg/min. HFNO used during airway management (i.e. intubation) can extend the tolerance for apnea, the time from end of physiological breathing until artificial ventilation is established. The main objective of this study is thus to investigate the variations of poorly ventilated lung units (i.e., silent spaces) as a surrogate for functional residual capacity measured by electrical impedance tomography to dynamically assess atelectasis formation and regression under apnoeic oxygenation with different flow rates.

Conditions

• Apnea
• Anesthesia
• Intubation Complication
• Children, Only
• Apnea Infant
• Atelectasis
• Ventilation Therapy; Complications

Interventions

OTHER

0.2 L/kg/min, FiO2 1.0 + continuous jaw thrust

Apnoeic Oxygenation with flow rate 0.2 L/kg/min using OptiFlow system by Fisher\&Paykel and an oxygen inspiration concentration FiO2 of 1.0

OTHER

2 L/kg/min, FiO2 1.0 + continuous jaw thrust

Apnoeic Oxygenation with flow rate 2 L/kg/min using OptiFlow system by Fisher\&Paykel and an oxygen inspiration concentration FiO2 of 1.0

OTHER

4 L/kg/min, FiO2 1.0 + continuous jaw thrust

Apnoeic Oxygenation with flow rate 4 L/kg/min using OptiFlow system by Fisher\&Paykel and an oxygen inspiration concentration FiO2 of 1.0

OTHER

2 L/kg/min using OptiFlow-Switch system, FiO2 1.0 + continuous jaw thrust

Apnoeic Oxygenation with flow rate 2 L/kg/min using OptiFlow-Switch system by Fisher\&Paykel and an oxygen inspiration concentration FiO2 of 1.0

Sponsors & Collaborators

• Thomas Riva

  lead OTHER

Principal Investigators

• Alexander Fuchs, M.D. · Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital,

• Thomas Riva, M.D. · Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital,

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

PARALLEL

Eligibility

Max Age

16 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-01-09

Primary Completion

2024-04-30

Completion

2024-05-02

Countries

• Switzerland

Study Locations