It has been demonstrated that Transnasal Humidified Rapid Insufflation Ventilatory Exchange used during preoxygenation for emergency surgery is at least equally effective as preoxygenation compared to standard tight fitting mask. Data from a recent study indicates that Transnasal Humidified Rapid Insufflation Ventilatory Exchange might decrease the risk of clinically relevant desaturation below 93% of arterial oxygen saturation. The limitations with our previous study is that it was done only during office hours (Mon-Friday 8 am to 4 pm) and that the power to detect the occurrence of desaturation was too low. Based on the above, the aim is now to conduct a clinical international multicenter study 24/7 with 450 patients and with a simplified protocol that allows the study to be done 24/7. This study is done with the aim of evaluation before implementing this novel technique of preoxygenation into clinical practice. The general purpose of this project is to compare a the preoxygenation technique based on Transnasal Humidified Rapid Insufflation Ventilatory Exchange with traditional preoxygenation with a tight fitting mask during rapid sequence induction (RSI) intubation in patients undergoing emergency surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
350
High flow nasal oxygen that is Transnasal Humidified Rapid Insufflation Ventilatory Exchange
100% oxygen via a tight fitting facemask
Centralsjukhuset Karlstad
Karlstad, Sweden
Linköping University Hospital
Linköping, Sweden
Karolinska University Hospital
Stockholm, Sweden
St Göran Hospital
Stockholm, Sweden
Södersjukhuset
Stockholm, Sweden
University Hospital of Bern
Bern, Switzerland
The number of patients that desaturates below 93% in SpO2 during pre oxygenation up to 1 minute after intubation
The number of patients that desaturates below 93% in SpO2 during pre oxygenation up to 1 minute after intubation
Time frame: From start of anaesthesia until 1 minute after tracheal intubation, that is normally after 3-4 minutes after anaesthesia induction
Lowest SpO2 during preoxygenation using THRIVE compared to traditional pre-oxygenation from time to first anesthetic drug given up to 1 minute after intubation.
Lowest SpO2 during preoxygenation using THRIVE compared to traditional pre-oxygenation from time to first anesthetic drug given up to 1 minute after intubation.
Time frame: From start of anaesthesia until 1 minute after tracheal intubation, that is normally after 3-4 minutes after anaesthesia induction
Level of end-tidal carbon dioxide in the first breath after intubation with Transnasal Humidified Rapid Insufflation Ventilatory Exchange oxygenation compared with traditional pre-oxygenation?
Level of end-tidal carbon dioxide in the first breath after intubation with Transnasal Humidified Rapid Insufflation Ventilatory Exchange oxygenation compared with traditional pre-oxygenation?
Time frame: At the first breath after tracheal intubation that is usually 2-4 minutes after induction of anaesthesia
Level of end-tidal O2 in the first breath after intubation with Transnasal Humidified Rapid Insufflation Ventilatory Exchange oxygenation compared with traditional pre-oxygenation?
Level of end-tidal O2 in the first breath after intubation with Transnasal Humidified Rapid Insufflation Ventilatory Exchange oxygenation compared with traditional pre-oxygenation?
Time frame: At the first breath after tracheal intubation that is usually 2-4 minutes after induction of anaesthesia
Incidence of gastric regurgitation between the groups?
Incidence of gastric regurgitation between the groups?
Time frame: From start of anaesthesia until 2 minutes after tracheal intubation, that is normally after 4-5 minutes after anaesthesia induction
Difference in numbers of patients being ventilated between the two groups?
Is there a difference in the number of patients that was ventilated before intubation between the two study groups?
Time frame: From start of anaesthesia until the patient is intubated, usually within 3-4 minutes
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