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Before going off to sleep patients are given oxygen to saturate blood with oxygen to extend time before a decrease in the level of oxygen in the blood occurs. During this period, obese patients have a faster decrease in the level of oxygen in their blood. This study uses a device called "high-flow nasal cannula" (HFNC), which delivers humidified high-flow oxygen through 2 small plastic tubes placed just inside nostrils. In the intensive care unit settings this device has been used extensively and has become a standard practice. Purpose of this study is to determine whether these high-flow nasal cannula increase the time safely when going to sleep during elective surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HFNC (High Flow Nasal Cannulae) | Experimental | High Flow Nasal Cannulae providing humidified, high-flow oxygen during induction of anesthesia |
|
| CON (control) | Active Comparator | Standard flow oxygen during induction of anesthesia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HFNC | Device | High flow nasal oxygen (60 l) under GA |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Measurement of safe apnea time | Safe apnea time, defined by time to desaturation (SpO2 > 95%) or apnea maximum up to 6 minutes | Maximum up to 6 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Highest EtCO2 | Highest EtCO2 on commencing ventilation | Every minute up to 5 minutes on commencing ventilation |
| Lowest SpO2 | Lowest SpO2 during intubation procedure |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Toronto Western Hospital | Toronto | Ontario | M5T 2S8 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31584919 | Derived | Wong DT, Dallaire A, Singh KP, Madhusudan P, Jackson T, Singh M, Wong J, Chung F. High-Flow Nasal Oxygen Improves Safe Apnea Time in Morbidly Obese Patients Undergoing General Anesthesia: A Randomized Controlled Trial. Anesth Analg. 2019 Oct;129(4):1130-1136. doi: 10.1213/ANE.0000000000003966. |
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Consented patients will be randomly assigned either to the interventional group (High Flow Nasal Cannula- HFNC) or to the control group (CON). The Group HFNC will be preoxygenated using HFNC and the Group CON will receive standard preoxygenation.
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| CON (control) |
| Device |
Standard oxygen (10-15 l) under GA |
|
| Every minute up to 5 minutes after intubation |
| Time to regain baseline SpO2 | Time to regain baseline SpO2 after intubation | Up to 5 minutes after intubation |