Usage of High Flow Nasal Cannula in Preventing Desaturations in Elderly Patients Going for Lower Limb Surgeries

Universiti Kebangsaan Malaysia Medical Centre50 enrolled

Overview

To study the effect of high flow nasal cannula in comparisons with nasoprong used intraoperatively in patients oxygenation status

To observe the effect of high flow nasal cannula used intraoperatively compared to normal oxygen therapy (nasoprong) at a same fraction of inspired oxygen (FiO2) in elderly patients who are going for orthopaedic surgeries under central neuraxial block. oxygenation will be access with intermittent blood gas. atelectasis will be access via chest x-ray , compared to a baseline chest x-ray, validated by a blinded radiologist

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Hypoxemia During Surgery Atelectasis

Interventions

high flow nasal cannulaDEVICE

high flow nasal cannula provides heated and humidified gas to the airways via nasal prongs at a prescribed accurate fraction of inspired oxygen (FiO2) ranging from 0.21 to 1.0 and with a higher flow rate of up to 60 litres per minute

nasoprong oxyen 2Litres per minuteDEVICE

nasoprong @L/min will deliver approximately a FiO2 of 0.3. subsequently, if incremental O2 is needed, patient will be provided with ventimask 40% and so forth

Eligibility

Sex: ALLMin age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. American Society of Anesthesiologists (ASA) I, II or III patients. 2. Patients age 60 years and above 3. Patients scheduled for total knee replacement therapy and hip surgeries under central neuraxial block under the elective and emergency list. Exclusion Criteria: 1. Patients with pre-operative spO2\<94% 2. Patients delirious or demented / unable to give consent. 3. Patients with pre-existing pneumonia (defined as the initiation of antibiotics for suspected infection with one or more of the following: new or changed sputum; new or changed lung opacities; fever; white blood cell count \>12 × 109 litre-1 )15 4. BMI ≥35

Locations (1)

Universiti Kebansaan Malaysia

Cheras, Kuala Lumpur, Malaysia

Outcomes

Primary Outcomes

Incident of intraoperative desaturation

desaturation is taken as any spO2 \<94%

Time frame: From induction time until end of surgery

Patient comfort on high flow nasal cannula

Patient rate comfort level using Visual Numerical Scale. The scale of 1 to 5 with 1 being extreme discomfort, 3 neutral and 5 extreme comfort

Time frame: At end of surgery till discharge to ward (recovery area)

Atelactasis

Incident of postoperative atelectasis by compraring the preoperative and postoperative chest x ray by a radiologist

Time frame: From end of operation until 24 hours post surgery

Secondary Outcomes

Length of hospital stay

Duration of hospital admission from the time of patient admitted to the hospital, until discharge from hospital

Time frame: Time of hospital admission to time of discharge up to 30 days which ever come first

Data from ClinicalTrials.gov

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