THRIVE (Transnasal Humidified Rapid-Insufflation Ventilatory Exchange) refers to the use of high-flow nasal cannula to augment the ability to oxygenate and ventilate a patient under general anesthesia. The use of high-flow nasal cannula oxygen supplementation during anesthesia for surgical procedures has been a recent development in the adult population, with limited data analyzing the pediatric population. This study will determine whether high flow nasal cannula oxygen supplementation during surgical or endoscopic procedures can prevent desaturation events in children under anesthesia and improve the outcomes of that surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
175
The use of high-flow nasal cannula to augment the ability to oxygenate and ventilate a patient under general anesthesia.
Lucile Packard Children's Hospital Stanford
Palo Alto, California, United States
Lurie Children's Hospital of Chicago
Chicago, Illinois, United States
Massachussetts Eye and Ear Harvard Medical School
Boston, Massachusetts, United States
Cincinnati Children's Hospital
Cincinnati, Ohio, United States
The University of Virginia
Charlottesville, Virginia, United States
Number of Participants With 4% Decrease From Baseline in Oxygen Desaturation Index
Oxygen desaturation index is defined as a 4% decrease in saturation from a 120 second rolling mean for greater than 10 seconds; data were recorded every 2 seconds while the procedure was being performed.
Time frame: Duration of surgery or procedure, which is generally less than 2 hours
Number of Participants With Desaturations <90%
Relative incidence of oxygen desaturation less than 90% as measured by pulse oximetry by second adjusted for post surgical diagnosis; data were recorded every 2 seconds while the procedure was being performed.
Time frame: Duration of surgery or procedure, which is generally less than 2 hours
Number of Participants Who Ever Either Fall Below 90% O2 or Drop 4% Below Baseline Saturation
Relative incidence of oxygen desaturation less than 90% as measured by pulse oximetry by second adjusted for post surgical diagnosis; data were recorded every 2 seconds while the procedure was being performed. Participants who experienced both a fall below 90% O2 and a 4% drop below baseline saturation are reported as having more than 1 event.
Time frame: Duration of surgery or procedure, which is generally less than 2 hours
Time-normalized Area Under Curve (AUC) of Desaturations <90%
Duration of oxygen desaturation less than 90% as measured by pulse oximetry by second by analyzing area under curve less than 90% (in those participants who experienced desaturation less than 90%), normalized as area under the curve / total time.
Time frame: Duration of surgery or procedure, which is generally less than 2 hours
Number of Participants With Surgical Interruptions Due to Desaturation
Number of surgical interruptions due to desaturation defined by a pause in surgical procedures due to need to provide airway intervention to improve patient's oxygen saturation, normalized to case length. Airway interventions may include jaw thrust, bag mask ventilation, and/or endotracheal intubations.
Time frame: Duration of surgery or procedure, which is generally less than 2 hours
Minimum Oxygen Saturation as a Measure of Desaturation Severity
Number of participants categorized by lowest oxygen saturation level during surgery (nadir). Lower saturation levels correspond to a lower level of oxygen in red blood cells.
Time frame: Duration of surgery or procedure by second, which is generally less than 2 hours
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