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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02216006
Other study ID # Dnr 2012/335
Secondary ID
Status Completed
Phase N/A
First received August 1, 2014
Last updated May 12, 2015
Start date September 2014
Est. completion date May 2015

Study information

Verified date May 2015
Source Landstinget Västmanland
Contact n/a
Is FDA regulated No
Health authority Sweden: Regional Ethical Review Board
Study type Interventional

Clinical Trial Summary

Atelectasis is common during and after general anesthesia. Atelectasis develops early if preoxygenation with 100% oxygen is used and continuously used during induction until endotracheal intubation. The investigators hypothesize that a rapid anti-preoxygenation maneuver immediately after confirming a successful intubation, reduces the area of atelectasis as investigated by computed tomography compared to a standard procedure.


Recruitment information / eligibility

Status Completed
Enrollment 24
Est. completion date May 2015
Est. primary completion date May 2015
Accepts healthy volunteers No
Gender Both
Age group 40 Years to 75 Years
Eligibility Inclusion Criteria:

- Healthy patients, American Society of Anesthesiology (ASA) I-II

- Patients scheduled for orthopaedic day case surgery in general anaesthesia

Exclusion Criteria:

- ASA class III or higher

- Body Mass Index (BMI) 30 or higher

- Arterial oxygen saturation (SpO2) <94% breathing air

- Chronic Obstructive Pulmonary Disease (COPD)

- Ischemic heart disease

- Haemoglobin <100g/L

- Known or anticipated difficult airway and/or intubation

- Active smokers and ex-smokers with a history of more than 6 pack years

- Need for interscalene or supraclavicular regional anaesthesia with risk of phrenic nerve paralysis

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Prevention


Related Conditions & MeSH terms


Intervention

Procedure:
Control group, conventional ventilatory settings
Handling of the airway during induction and intubation is performed in a conventional manner. Initial ventilatory settings are also done in a conventional manner. As soon as correct position of the endotracheal tube is confirmed, controlled ventilation is started with a tidal volume of 7 mL/kg ideal body weight, PEEP 6 or 8 cm H2O (8 if BMI >25) and a respiratory frequency of 10. The fresh gas flow is set to 1 Liter per minute with an oxygen mixture of 40%, aiming for an inspired FiO2 of 30-35%. Unless the patient´s SpO2 falls below 90%, the FiO2 remains unchanged throughout the procedure.
High fresh gas flow, high minute ventilation
Handling of the airway during induction and intubation is performed in a conventional manner. Immediately after confirming a successful intubation, the effect of preoxygenation is eliminated with a fresh gas flow of 10 L/min of air, delivered with volume controlled ventilation consisting of tidal volumes of approximately 15 ml/kg ideal body weight, a positive expiratory pressure of 10 cm H20 and a respiratory frequency of 10. As soon as the end tidal O2 reaches 25%, the ventilator settings are adjusted to normal values (same as in the control group), i.e. tidal volume 7 mL/kg ideal body weight, PEEP 6 or 8 cm H2O (8 if BMI >25). The mixture of oxygen in the fresh gas is increased to 40% and the fresh gas flow is set to 1 Liter per minute, aiming for an inspired FiO2 of 30-35%. Unless the patient´s SpO2 falls below 90%, the FiO2 remains unchanged throughout the procedure.

Locations

Country Name City State
Sweden Landstinget Västmanland Köping Västmanland

Sponsors (1)

Lead Sponsor Collaborator
Landstinget Västmanland

Country where clinical trial is conducted

Sweden, 

Outcome

Type Measure Description Time frame Safety issue
Primary Atelectasis The area of atelectasis in the lungs is assessed by computed tomography (CT) 10 mm above the dome of the right diaphragm and expressed in cm2 and as % of the total lung area in the particular scan. Within 1-2 hours, just before emergence from anesthesia Yes
Secondary Arterial blood gases Within 2-3 hours perioperatively Yes
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