Atelectasis After Inhalation or Intravenous Induction in Pediatric Anesthesia

Completed

• Conditions: Atelectasis; Pediatric Anesthesia
• Interventions: Other: Type of anesthesia induction

• Registration Number: NCT06069414
• Lead Sponsor: Vittore Buzzi Children's Hospital

Brief Summary

Children have a highly compliant chest wall and atelectasis formation occurs often during pediatric anesthesia. Inhalation induction is commonly performed in pediatric anesthesia but it is still unclear if this can have an effect on the development of atelectasis. Aim of this study is to investigate the impact of inhalation versus intravenous induction on atelectasis formation during anesthesia induction in children. Atelectasis will be evaluated with lung ultrasound before induction and right after induction.

Detailed Description

Respiratory complications, among which atelectasis, are a common cause of adverse events in pediatric anesthesia. Lung ultrasound (LUS) examination is a point of care, non-invasive, radiation-free tool with high sensitivity and specificity for the identification of anesthesia-induced atelectasis in children.

Inhalation induction is commonly performed in pediatric anesthesia to avoid pain at venipuncture or to facilitate vein cannulation. This technique has been associated with a higher rate of respiratory adverse events but no study has investigated the role of inhalation or intravenous induction on lung atelectasis development in pediatric anesthesia.

The investigators will perform this study aiming to describe the impact of inhalation versus intravenous induction technique on atelectasis formation during anesthesia induction in children of different ages.

Study Timeline

• Study Start: 2023-04-01
• Study First Submitted: 2023-09-13
• Primary Completion: 2023-10-01
• Study First Submitted QC: 2023-10-04
• Study First Posted: 2023-10-05
• Study Completion: 2023-11-01
• Status Verified: 2024-04
• Last Update Submitted: 2024-04-15
• Last Update Posted: 2024-04-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 326

Inclusion Criteria

• scheduled for elective surgery under general anesthesia
• parental consent

Exclusion Criteria

• American Society of Anesthesiologists (ASA) physical status III-VI
• neuromuscular disease
• chronic lung disease
• cardiopathy
• thoracic cage malformations
• chronic home ventilation (either invasive or non-invasive)
• positive history of foreign body inhalation
• required immediate life-saving procedures
• lack of parental consent

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Intravenous induction	Type of anesthesia induction	Patients who will be induced with intravenous anesthetics
Inhalatory induction	Type of anesthesia induction	Patients who will be induced via mask with inhalators anesthetic gases

Primary Outcome Measures

Name	Time	Method
Signs of atelectasis	Upon completion of induction and and subsequent controls at end of surgery and 1 postoperative day	Number of lung areas presenting a sub pleural consolidation
Global LUS score	Upon completion of induction and subsequent controls at end of surgery and 1 postoperative day	Sum of the LUS scores given to all the lung areas. Score points vary from 0 to 3, where 0 means normality of the lung and 3 refers to complete loss of aeration-tissue-like pattern or consolidation.

Trial Locations

Locations (1)

Vittore Buzzi Children's Hospital; 🇮🇹 Milan, Italy