MedPath

Comparison of Two FiO2 (1 or 0.5) for Tracheal Extubation in Post-anesthesia Care Unit

Not Applicable
Completed
Conditions
Hypoxemia
Atelectasis
Postoperative Complications
Anesthesia
Hyperoxia
Interventions
Other: FiO2 1
Other: FiO2 0.5
Registration Number
NCT04879290
Lead Sponsor
University Hospital, Caen
Brief Summary

The purpose of the study is to assess the optimal fraction of inspired oxygen (0.5 or 1) for extubation or removal of a supraglottic airway device after general anesthesia.

Detailed Description

During pre-anesthesia visit, eligible patients receive oral and written information of the study and potential risks.

In the operating room all patients giving a written informed consent will undergo at the end of surgery a screening to determine eligibility for study entry.

Before emergence from general anesthesia, patients who meet the eligibility requirements will be randomized in a open label manner to receive a 0.5 or 1 FiO2.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
119
Inclusion Criteria
  • Patients undergoing general anesthesia, with invasive mechanical ventilation including an airway device (supraglottic airway device or tracheal tube) at their arrival in PACU.
  • ASA physical status classification 1, 2, or 3 stabilized.
  • Surgery performed in emergency operating room department including vascular, digestive, urological and minor trauma surgery or surgery performed in head and neck anesthesia pole block including anterior cervical spine, lumbar disc herniation, cranioplasty, nerve stimulator, vertebroplasty, narrow lumbar canal, simple arthrodesis (less than or equal to two stages), otological, ophthalmological and skin surgery.
Exclusion Criteria
  • Per-operative hemodynamic instability.
  • Patients with a BMI greater than 35.
  • Patients classified as difficult to intubate and / or ventilate.
  • Heavy surgeries (operating time greater than 4 hours).
  • Patient requiring postoperative non invasive mechanical ventilation
  • Patients with diagnosed COPD
  • SPO2 in room air < 96% before the intervention.
  • Any patient under guardianship.
  • Pre-operative and / or intra-operative morphine intake.
  • Surgical management of the upper airways (ex : tonsillectomy)
  • Pregnant and lactating women.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control Group FiO2=1FiO2 1FiO2 = 1 (100%) 10mn before emergence of general anesthesia
Intervention Group FiO2 0.5FiO2 0.5Fi02 = 0.5 (50%) 10mn before emergence of general anesthesia
Primary Outcome Measures
NameTimeMethod
Decrease of oxygen saturationDuration of stay in post-anesthesia care unit, approximately one hour

Proportions of patients that present a decrease of 4 points of peripheral capillary oxygen saturation (SpO2) measured with pulse oximetry after extubation compared to their baseline room air SpO2

Secondary Outcome Measures
NameTimeMethod
PACU length of stayOne hour

Length of stay in post-anesthesia care unit

Duration of emergenceUp to one hour

Elapsed Time between cessation of sedation and extubation (minutes)

Majored decrease of oxygen saturationOne hour

Proportions of patients that present a decrease of 6 points of SpO2 after extubation compared to their baseline room air SpO2

Primary Outcome TimingUp to one hour

Elapsed time between extubation and decrease of oxygen saturation (minutes)

Number of risk factorsOne hour

Number of factors associated with episodes of hypoxemia : bronchospasm, bronchial congestion (profuse secretions with the need to aspirate the patient several times), loss of upper airway muscle tonus (fall of the tongue).

Corrective measuresOne hour

Number of corrective measures (method and oxygen supply equipment used) after hypoxemia and proportion of success.

Trial Locations

Locations (1)

University Hospital, Caen

🇫🇷

Caen, France

© Copyright 2025. All Rights Reserved by MedPath