Ventilation through the small endotracheal tube is not an uncommon situation. The indications for it differ from elective upper airway surgery to emergency ventilation through needle cricothyrotomy. Conventionally, ventilation through small endotracheal tubes has been challenging by jet ventilation with subsequent risk of barotrauma and inadequate gas exchange. Expiration during jet ventilation occurs passively.
Upper airway endoscopy (micro laryngoscopy (MLS), pan endoscopy) is a minor upper airway procedure needing short duration general anesthesia, small calibrate endotracheal tube and manipulation of the airway. Because of airway manipulation and the surgery involves the airway, which is being shared with the anesthesiologist, there is a risk of interruption of ventilation, oxygenation and loss of airway in addition to inherent complications of surgery. Methods: After the patients will receive information about the study and informed consent will be taken. The patients will be randomized. In the control group, (group A) ventilation will be performed according to the routine big endotracheal tube. In the treatment group (group B), the ultra-thin ventilation tube will be placed using laryngoscopy. All other treatment will be unchanged. Data collection will be started 5 min after the initiation of the study. Demographic data, Past medical history, and examinations data will be collected after acceptance of the patient to be enrolled into the study and other ventilation parameters will be collected 5 min after the start of the the study which is Skin incision Primary endpoint is; to evaluate whether the Flow Controlled Ventilation (FCV) can also achieve adequate oxygenation and ventilation through small tube or not.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Mechanically ventilated using Flow Controlled Ventilation (FCV)
ACC&HGH, Hamad Medical Corporation
Doha, Doah, Qatar
RECRUITINGMeasurement of dynamic chest wall compliance (mL/mbar)
Dynamic chest wall compliance changes due to Flow Controlled Ventilation (FCV) in comparison to routine Volume Controlled Ventilation(VCV)
Time frame: During study time intra-operatively
Airway Resistance (mbar*s/L)
This measures the airway resistance changes due to Flow Controlled Ventilation (FCV) in comparison to the traditional Volume Controlled Ventilation(VCV)
Time frame: During procedure time and intra-operatively
Oxygen concentration (SPaO2)and tension(PaO2) in the blood (% and mmHg respectively)
This will measure the patient oxygenation during intervention in both studied groups and using the arterial blood gases
Time frame: Intra-operatively during procedure time
Carbon dioxide in the blood (PaCO2) and the trachea (ECO2) mmHg.
This measures the patient ventilation during intervention in both studied groups using capnogram and arterial blood gases
Time frame: During surgical procedure intra-operatively
Postoperative sore throat according the Visual Analogue Scale (VAS)
Postoperative sore throat after 2 and 24 hours using the VAS score (0-10). (Zero=no pain and 10 = for the most sever pain.
Time frame: After surgical procedure (2 and 24) hours.
Kink of the small size tube (Tritube) (Yes/No)
Kink of the small (Tritube) (using machine alarms for obstruction and visual inspection) so will be (yes) for partial or complete obstruction and (no) for the absence of obstruction)
Time frame: During surgical procedure
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Surgeon satisfaction instance scale (1-5)
the Surgeon satisfaction score according the space free for the surgery which range from (1= poor, 2= medium, 3= good, 4= very good, and 5= excellent).
Time frame: During surgical procedure