Atelectasis After Inhalation or Intravenous Induction in Pediatric Anesthesia

Vittore Buzzi Children's Hospital326 enrolled

Overview

Children have a highly compliant chest wall and atelectasis formation occurs often during pediatric anesthesia. Inhalation induction is commonly performed in pediatric anesthesia but it is still unclear if this can have an effect on the development of atelectasis. Aim of this study is to investigate the impact of inhalation versus intravenous induction on atelectasis formation during anesthesia induction in children. Atelectasis will be evaluated with lung ultrasound before induction and right after induction.

Respiratory complications, among which atelectasis, are a common cause of adverse events in pediatric anesthesia. Lung ultrasound (LUS) examination is a point of care, non-invasive, radiation-free tool with high sensitivity and specificity for the identification of anesthesia-induced atelectasis in children. Inhalation induction is commonly performed in pediatric anesthesia to avoid pain at venipuncture or to facilitate vein cannulation. This technique has been associated with a higher rate of respiratory adverse events but no study has investigated the role of inhalation or intravenous induction on lung atelectasis development in pediatric anesthesia. The investigators will perform this study aiming to describe the impact of inhalation versus intravenous induction technique on atelectasis formation during anesthesia induction in children of different ages.

Study Type

OBSERVATIONAL

Enrollment

326

Conditions

Atelectasis Pediatric Anesthesia

Interventions

Type of anesthesia inductionOTHER

Patients will receive inhalatory or intravenous anesthesia at their choice; both groups will be evaluated with lung ultrasound after induction to detect ultrasonografic signs of atelectasis

Eligibility

Sex: ALLMin age: 0 YearsMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * scheduled for elective surgery under general anesthesia * parental consent Exclusion Criteria: * American Society of Anesthesiologists (ASA) physical status III-VI * neuromuscular disease * chronic lung disease * cardiopathy * thoracic cage malformations * chronic home ventilation (either invasive or non-invasive) * positive history of foreign body inhalation * required immediate life-saving procedures * lack of parental consent

Locations (1)

Vittore Buzzi Children's Hospital

Milan, Italy

Outcomes

Primary Outcomes

Global LUS score

Sum of the LUS scores given to all the lung areas. Score points vary from 0 to 3, where 0 means normality of the lung and 3 refers to complete loss of aeration-tissue-like pattern or consolidation.

Time frame: Upon completion of induction and subsequent controls at end of surgery and 1 postoperative day

Signs of atelectasis

Number of lung areas presenting a sub pleural consolidation

Time frame: Upon completion of induction and and subsequent controls at end of surgery and 1 postoperative day

Data from ClinicalTrials.gov

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