Hyperoxygenation in Anesthetized Children

Walid HABRE58 enrolled

Overview

This study is aiming at assessing the effect of inspired oxygen fraction during general anesthesia on children's lung mechanics and volume. More specifically, the temporal change in end-expiratory lung volume (EELV) and respiratory system resistance and elastance during the perioperative period will be characterized in order to define the the effect of high inspired fraction of oxygen on lung function.

High-enriched oxygen fractions (FiO2)are common practice during general anesthesia both to ensure normoxemia despite intrapulmonary shunts and to provide security in case of adverse events. However, high-inspired oxygen fraction may decrease ventilation-perfusion ratios and its benefits are still unproven in children. The investigators aim at assessing the benefits and potential adverse effects of high-inspired oxygen fraction in two groups of children receiving either 30% FiO2 or 80% FiO2 during maintenance of anesthesia. Nitrogen multiple breath washout technique and forced oscillation technique will be used to measure end-expiratory lung volume (EELV) and airway resistance (Rrs) and respiratory elastance (Xrs) respectively. These measurements will be obtained before the general anesthesia, one hour and one day after the procedure.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

TRIPLE

Enrollment

Conditions

Hyperoxia

Interventions

OxygenOTHER

Delivery of high concentration of oxygen at induction, maintenance and extubation of children under general anesthesia.

Eligibility

Sex: ALLMin age: 4 YearsMax age: 16 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiology (ASA) physical status I and II * Body mass index \< 30 kg/m2 * Scheduled for elective surgery in the supine position lasting \< 200 min * General Anesthesia with tracheal intubation Exclusion Criteria: * Patients hospitalized more than 24 h before the operation * History or clinical signs of heart or lung disease * Upper respiratory tract infection \< 2 weeks prior to surgery * Predictable difficult airway * History of apnea * Abdominal or thoracic surgery * Lack of cooperation, language barrier

Locations (1)

Geneva Children's Hospital, Pediatric Anesthesia Unit

Geneva, Switzerland

Outcomes

Primary Outcomes

Postoperative changes in lung volume in children receiving low (35%) or high (80%) intraoperative fraction of oxygen

Measurement of end-expiratory lung volume by nitrogen wash-out technique

Time frame: 24 hours

Postoperative changes in airway resistance in children receiving low (35%) or high (80%) intraoperative fraction of oxygen

Measurement of airway resistance and respiratory system elastance by forced oscillation technique

Time frame: 24 hours

Secondary Outcomes

Respiratory complications

Assessing intraoperative (bronchospasm, laryngospasm, oxygen desaturation, airway obstruction) and postoperative (hypoxemia, atelectasis, pneumonia) complications

Time frame: 1 month

Postoperative nausea and vomiting

Time frame: 24 hours

Data from ClinicalTrials.gov

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