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Oxygenation with high-flow nasal cannula with 100% oxygen has only been evaluated in a limited number of studies. Although data are convincing it is of importance to evaluate this new concept in our department before implementing it into clinical practice.
The general purpose of this project is to evaluate a new ventilation strategy during ENT-surgery based on oxygenation with high-flow nasal cannula with 100% oxygen with focus on gas exchange.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Normoventilation | No Intervention | The patients will be normoventilated before anesthesia | |
| Hyperventilation | Experimental | Prior to anesthesia, the patients will hyperventilate during 2 mins or until symptoms from the central nervous system (e.g. dizziness). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hyperventilation | Procedure |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in arterial carbon dioxide (pCO2) | From start of anaesthesia to end of apnoea oxygenation or max 30 minutes | |
| Change in arterial pH | From start of anaesthesia to end of apnoea oxygenation or max 30 minutes | |
| Change in arterial oxygen tension (pO2) | From start of anaesthesia to end of apnoea oxygenation or max 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Does hyperventilation prior to anaesthesia and apnoea oxygenation cause any difference in pCO2 in the end of the apnea (i.e. at up to 30 minutes) compared to normoventilation? | In the end of the apnoea period, i.e. at approximately 20 minutes | |
| Does hyperventilation prior to anaesthesia and apnoea oxygenation cause any difference in pH in the end of the apnea (i.e. at up to 30 minutes) compared to normoventilation? |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Malin Jonsson Fagerlund, MD, PhD | Karolinska University Hospital and Karolinska Institutet | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28403407 | Derived | Gustafsson IM, Lodenius A, Tunelli J, Ullman J, Jonsson Fagerlund M. Apnoeic oxygenation in adults under general anaesthesia using Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) - a physiological study. Br J Anaesth. 2017 Apr 1;118(4):610-617. doi: 10.1093/bja/aex036. |
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| ID | Term |
|---|---|
| D053120 | Respiratory Aspiration |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| In the end of the apnoea period, i.e. at approximately 20 minutes |
| Does hyperventilation prior to anaesthesia and apnoea oxygenation cause any difference in pO2 in the end of the apnea (i.e. at up to 30 minutes) compared to normoventilation? | In the end of the apnoea period, i.e. at approximately 20 minutes |
| Does the high oxygen content cause atelectasis measures as change in relation between pCO2 and end tidal carbon dioxide | Until discharge from the postoperative unit, often max 2 hours |