This is a randomized clinical trial investigating the utility of apneic oxygenation via high flow nasal cannulae during airway management for infants general anaesthesia. Three groups will be compared, a control group at 0 L/min, a 0,2L/Kg/min and a 1L/Kg/min group. The primary outcome will be the time (in seconds) between onset of apnea and one of theses end-points : desaturation (SPO2 \<95%) or Airway management completed.
Airway management can be a life saving therapy. One major complication that may occur during airway management is a lack of oxygen in the blood, especially in peadiatric population, due to anatomical and physiological considerations. If severe or prolonged, this lack of oxygen can result in permanent brain damage, damage to other vital organs or even death. Pre-oxygenation prior to induction of anaesthesia is standard practice to prevent desaturation and hypoxemia. Apnoeic oxygenation in adults is effective and prolongs the time to desaturation. Apneic oxygenation is a novel method of delivering oxygen to a patient despite a lack of active respiration (i.e. the patient is not breathing on their own and the investigators are not providing the patient an artificial breath). The simplest and least invasive method to provide apneic oxygenation is the application of oxygen through nasal cannula during airway management. The effectiveness of apnoeic oxygenation in the adult is well document, especially in bariatric population or ICU, however only few study are interesting about pediatric population. Recent studies suggest that high flow is similar to low flow oxygenotherapy. Therefore, the aim of this study was to investigate the effectiveness of apnoeic oxygenation during airway management in infants. This is a randomized clinical trial investigating the utility of apneic oxygenation via high flow nasal cannula during airway management for infant's general anesthesia. Three groups will be compared, a control group at 0 L/min, a 0,2L/Kg/min and a 1L/Kg/min group. The primary outcome will be the time (in seconds) between onset of apnea and one of these end-points : desaturation (SPO2 \<95%) or Airway management completed. All infants included will receive french actual standard of care concerning general anesthesia and peri-operative medicine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
Apnoeic Oxygenation by High Flow Nasal Cannulae
CHU
Clermont-Ferrand, France
RECRUITINGTime between apnoea and issues
Time, in seconds, between the onset of Apnoea (No EtCO2 on the capnogram) and one of these two Issues : * SpO2\< 95% * Airway Management Completed (Orotracheal intubation completed and 3 similar capnograms on the respirator)
Time frame: Start at the onset of Apnoea
Minimal SpO2 during the procedure (%)
Minimal SpO2 recorded during the onset of apnoea and airway management completed
Time frame: Between Onset of apnoea and airway management completed
Time to SpO2 = 90% (in seconds)
Time between onset of apnoea and SpO2 = 90%, if it occurs, even if mask ventilation is started at Spo2 =95%
Time frame: During Airway Management, after Apnoea Onset
Numbers of Laryngoscopy attempts (n)
Numbers of Laryngoscopy needed to secure Airways
Time frame: During Airway management
Need to Face Mask Reventilating (Yes/No)
: Incidence of Face Mask Reventilating during Airway management, needed by Sp02 reach under 95%
Time frame: During Airway management
Area under SpO2 curve
AUC of SpO2 recorded every 10 seconds
Time frame: During Airway management
Respiratory Events (Incidence and type)
Incidence of respiratory diseases during Airway management (Bronchospasm, Pneumothorax, Laryngospasm, Laryngeal Oedema)
Time frame: During Airway management
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PREVENTION
Masking
TRIPLE
Enrollment
72