Oxygenation Via Nasal Cannulae Prevents Arterial Hypoxemia During the Apneic Period in Paralyzed Patients
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Hypoxia
- Sponsor
- University of Manitoba
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- PaO2 in mmHg (arterial oxygen tension as measured by an arterial blood gas)
- Status
- Completed
- Last Updated
- 13 years ago
Overview
Brief Summary
The purpose of the study is to evaluate the effectiveness of continuous oxygen provided by nasal prongs in preventing or delaying hypoxemia during the apneic period that occurs after induction of general anesthesia. This will be evaluated by measuring the arterial oxygen tension (PaO2).
The study will also evaluate whether there is any difference in PaO2 when using nasal prongs with flow rates of 5 L/minute versus 10 L/minute of oxygen.
Detailed Description
Certain patient populations are at risk for rapid desaturation and the rapid development of hypoxemia (eg. morbidly obese and pregnant patients). Using pulse oximetry, it has already been shown that oxygen provided with a catheter inserted into the nasopharynx is effective in delaying the desaturation that occurs with apnea before the trachea is intubated. It has also been shown that apneic oxygenation with nasal prongs at 5 L/min during fibreoptic intubation can delay the onset of hypoxemia. The study will evaluate whether there is any significant difference in the PaO2 (arterial oxygen tension, as measured by an arterial blood gas) when nasal prongs are used to provide apneic oxygenation in paralyzed patients at flows of 5 L/min compared to 10 L/min. The study aims to demonstrate that apneic oxygenation using nasal prongs is effective in preventing or delaying hypoxemia (by measuring PaO2), and that this technique may be used to prevent morbidity and mortality in all clinical areas (not only in the Operating Room environment) where airway management is undertaken.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Healthy males and females
- •ASA Class 1-3
- •Ages of 18 to 65
- •Elective surgery under general anesthesia
- •No evidence of significant cardiac, respiratory or gastrointestinal disease
- •No contraindications to the insertion of a radial arterial catheter
Exclusion Criteria
- •Evidence of a difficult airway (expected difficult intubation identified from patient history or clinical examination)
- •Features suggestive of difficult bag mask ventilation
- •Significant GERD requiring medical therapy
- •Significant respiratory disease (including severe asthma or COPD, oxygen dependency, pulmonary hypertension)
- •Significant cardiac disease (ischemic heart disease, severe aortic and mitral stenosis and/or regurgitation, EF \< 50% if known)
- •Inability to lie flat (skeletal deformities, orthopnea, congestive cardiac failure)
- •PaO2 \< 200 mmHg on ABG after adequate preoxygenation to an ETO2 \> 85%
- •Hemoglobin \< 100 g/L
- •BMI \> 40 kg/ m2
- •Patient unwillingness or refusal to participate
Outcomes
Primary Outcomes
PaO2 in mmHg (arterial oxygen tension as measured by an arterial blood gas)
Time Frame: Arterial blood gases taken at one minute intervals post induction in the apneic period, for a total of 4 measurements