Pre-oxygenation With High-flow Nasal Cannula in Pregnant Women Undergoing Caesarian Section Under General Anesthesia - a Pilot Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Pregnancy Related
- Sponsor
- Karolinska University Hospital
- Enrollment
- 34
- Locations
- 4
- Primary Endpoint
- Number of patients with peripheral arterial oxygen saturation below 93% from start of pre-oxygenation until one minute after tracheal intubation and comparison between intervention and control
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
The investigators and other groups have demonstrated that high-flow nasal oxygen used during preoxygenation for emergency surgery is at least equally effective as preoxygenation compared to standard tight fitting mask. The investigators also have data from a recent study that indicates that high-flow nasal oxygen might decrease the risk of clinically relevant desaturation below 93% of arterial oxygen saturation.
The studies investigating the concept of high-flow nasal oxygen has up to this date excluded pregnant women. Pregnant woman is a patient group with known difficulties to maintain adequate saturation levels during apnoea. Due to smaller functional residual capacity their oxygen stores after preoxygenation are smaller compared to patients with a normal body mass index. The pregnant woman also have a higher oxygen demand and metabolism due to the growing placenta and the fetus. Pregnant women are therefore a patient group where a method that could prolong time until desaturation would be even more valuable and potentially could save lives.
Based on the above, the investigators now aim to conduct a clinical pilot study, where pregnant women undergoing caesarian section under general anesthesia are pre and perioxygenated with high-flow nasal oxygen. Data from that group will be compared with patients preoxygenated in a traditional manner with tight facemask. This study is done to evaluate an established technique on a patient category that in theory could gain a lot from it.
Investigators
Malin Jonsson Fagerlund
Senior Consultant, Associate Professor
Karolinska University Hospital
Eligibility Criteria
Inclusion Criteria
- •Adult, \>18 years old
- •Caesarian section under general anesthesia.
- •Pregnant in week 30 or later
- •Capable of understanding the study information and signing the written consent.
Exclusion Criteria
- •Dependency on non-invasive ventilation to maintain oxygen saturation
Outcomes
Primary Outcomes
Number of patients with peripheral arterial oxygen saturation below 93% from start of pre-oxygenation until one minute after tracheal intubation and comparison between intervention and control
Time Frame: Up to 1 minute after intubation
arterial peripheral oxygen saturation
Secondary Outcomes
- Comparison of Endtidal concentration of oxygen after intubation between intervention and control(The first breaths after intubation eg. within 20 seconds of intubation)
- Comparison of Endtidal carbondioxide concentration after intubation between intervention and control(The first breaths after intubation eg. within 20 seconds of intubation)
- Comparison of Number of patients with regurgitation of gastric contents between intervention and control(During intubation eg up to 0 seconds after intubation)