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Importance of Integrated Pulmonary Index in Pediatric Bronchoscopy

Not Applicable
Completed
Conditions
Respiratory Monitoring
Monitored Anesthesia Care
Interventions
Device: Integrated Pulmonary Index (IPI) monitoring
Registration Number
NCT05137587
Lead Sponsor
Marmara University
Brief Summary

Integrated Pulmonary Index (IPI) is a tool that provides numerical values on a scale of 1-10 based on physiological parameters such as peripheral oxygen saturation (SpO2), pulse rate, respiratory rate, end-tidal carbon dioxide (ETCO2). It is a valuable monitor for sedation procedures and can provide early warning during cardiorespiratory derangements. In this study, we wanted to evaluate the value of IPI in cases of pediatric bronchoscopy performed under sedation. Our outcome measure will be the correlation of IPI values with standard monitoring parameters.

Detailed Description

Bronchoscopy is a procedure that is frequently applied in diagnostic or interventional conditions like hemoptysis, tracheobronchial stenosis, malignancy, recurrent lung infections, etc. It is routinely performed under general anesthesia or sedation in pediatric cases. In our clinic, we routinely perform diagnostic or interventional pediatric bronchoscopy procedures with an anesthesia team outside the operating room under monitored anesthetic care (MAC). Routine monitoring of MAC consists of electrocardiography (ECG), non-invasive blood pressure (NIBP), and peripheral oxygen saturation (SpO2). These monitorizations are described as minimum in many practice guidelines, and sometimes monitors such as end-tidal carbon dioxide (ETCO2), body temperature, analgesia/nociception index (ANI) can be added to them.

Integrated Pulmonary Index (IPI) is a tool that provides numerical values on a scale of 1-10 based on physiological parameters such as peripheral oxygen saturation (SpO2), pulse rate, respiratory rate, end-tidal carbon dioxide (ETCO2).(1,2) When these parameters exceed physiological limits, patients require interventions consisting of various maneuvers or drug administration in order to maintain the normal functioning of the cardiorespiratory system. If we look at the scoring, a score of 8-10 is considered normal, a score of 5-7 indicates a situation that may require intervention, and a score of 1-4 indicates that the patient needs intervention.

The above-mentioned IPI is a relatively new tool, and there is limited data in the literature regarding its usability in patients undergoing interventional procedures under MAC.(3,4) In this study, we wanted to evaluate the safety of IPI in cases of pediatric bronchoscopy performed under sedation. Routine monitoring and drug applications for the procedure will be in accordance with the institutional protocols, and additional IPI monitoring will be performed. Our outcome measure will be the correlation of IPI values with standard monitoring parameters.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  • ASA 1-3 physical status
  • Elective upper or lower gastrointestinal tract endoscopy
Exclusion Criteria
  • ASA physical status of 4 or more
  • Patients with any contraindication for off-site anesthesia

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group PpropofolPatients sedated with propofol
Group KIntegrated Pulmonary Index (IPI) monitoringPatients sedated with ketamine
Group PIntegrated Pulmonary Index (IPI) monitoringPatients sedated with propofol
Group KketaminePatients sedated with ketamine
Primary Outcome Measures
NameTimeMethod
IPI-KetamineThroughout the sedation procedure

Correlation of ketamine and IPI values

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Marmara University School of Medicine

🇹🇷

Istanbul, Pendik, Turkey

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