Not provided
Not provided
Not provided
Not provided
No inclusion after the 2 years of approval of the human subject review, even after 2 years of prorogation
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Preoxygenation is recommended before performing tracheal intubation. In intensive care units (ICU) patients, there is no specific recommendation regarding the duration of preoxygenation, which usually is applied for 3 to 5 minutes. Monitoring the effectiveness of preoxygenation with end-tidal oxygen concentration (EtO2) is strongly recommended in the operating room but it is never used in ICUs. The first aim of this pilot study is to assess the effect of the preoxygenation duration on EtO2, and secondarily, as an exploratory objective, to determine whether targeting a given value of EtO2 during preoxygenation might insure a safer intubation than when targeting pulse oximetry (SpO2).
This is a multicenter randomized controlled pilot study. 110 patients who require intubation in the ICU will be randomly assigned, with a 1:1 ratio, to 3 or 5 minutes of preoxygenation duration. EtO2 will be continuously measured but hidden to the clinician. The primary outcome measure will be the obtention of an optimal preoxygenation defined by an EtO2 >90%. Secondary outcomes include the occurrence of hypoxia and complications during the procedure.
A pulse oximetry (SpO2) greater than or equal to 96% (SpO2 ≥ 96%) at the end of preoxygenation will be the target in each group. If at the end of the preoxygenation, SpO2 is still lower than 96%, clinician will be allowed to extend the duration of preoxygenation (up to 5 minutes in the 3 minutes period of preoxygenation group and up to 8 minutes in the 5 minutes period of preoxygenation group).
End-tidal oxygen concentration (EtO2) will be measured during preoxygenation and will be hidden to the clinician in order to not influence the duration of preoxygenation.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 3 minutes period of preoxygenation | Experimental | 3 minutes of preoxygenation : participants in this group will receive 3 minutes of preoxygenation before intubation |
|
| 5 minutes period of preoxygenation | Experimental | 5 minutes of preoxygenation: participants in this group will receive 5 minutes of preoxygenation before intubation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Preoxygenation | Other | participants will receive 3 minutes of preoxygenation before intubation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of patients who reach an EtO2 of 90% | To compare the percentage of patients who reach an EtO2 of 90% or higher (optimal preoxygenation) at the end of the preoxygenation period between patients randomized in the 3-min and those randomized in the 5-min preoxygenation duration group. | 3 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Expired oxygen fraction (FeO2) | FeO2 will be recorded at the end of the preoxygenation period | end of the preoxygenation period |
| Incidence of hypoxemia | Hypoxemia will be defined by SpO2<90% during the intubation procedure |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Mai-ANh NAY, MD | CHR Orléans | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CH de DAX | Dax | 40100 | France | |||
| CHR d'Orléans |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22318634 | Background | Carrillo A, Gonzalez-Diaz G, Ferrer M, Martinez-Quintana ME, Lopez-Martinez A, Llamas N, Alcazar M, Torres A. Non-invasive ventilation in community-acquired pneumonia and severe acute respiratory failure. Intensive Care Med. 2012 Mar;38(3):458-66. doi: 10.1007/s00134-012-2475-6. Epub 2012 Feb 9. | |
| 24962719 | Background |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Pilot study Randomized controlled multicenter trial Ratio 1:1
Not provided
Not provided
Not provided
Not provided
| Preoxygenation (longer) | Other | participants will receive 5 minutes of preoxygenation before intubation |
|
| 5 minutes after intubation |
| Incidence of severe hypoxemia | Severe hypoxemia will be defined by SpO2<80% for more than 5 seconds during the intubation procedure from the end of preoxygenation to 5 minutes after invasive mechanical ventilation | End of preoxygenation |
| Incidence of severe complications | Severs complications occuring within 30 minutes following the intubation procedure will be evaluate and compare between the two groups | 30 minutes after intubation |
| Lowest Pulsed saturation with Oxygen (SpO2) | The lowest SPO2 obtained within 30 minutes after the end of preoxygenation will be compared between the 2 groups | 30 minutes after the end of preoxygenation |
| Expired oxygen fraction (FeO2) | FeO2 during preoxygenation will be recorded every minutes | Through preoxygenantion, i.e., an average of 4 minutes (a minimum of 3 and a maximum of 8 minutes) |
| Partial Pressure of Oxygen (PaO2) | Measurement of PaO2 | 0 minute |
| Partial Pressure of Oxygen | Measurement of PaO2 at the end of the preoxygenation | at the 4th minute on average (3rd or 5th minute depending on the randomisation group) |
| Orléans |
| 45067 |
| France |
| CHRU de TOURS | Tours | 37000 | France |
| Thille AW, Frat JP, Brun-Buisson C. Trends in use and benefits of non-invasive ventilation as first-line therapy in acute respiratory failure. Intensive Care Med. 2014 Aug;40(8):1179-80. doi: 10.1007/s00134-014-3370-0. Epub 2014 Jun 25. No abstract available. |
| 24480997 | Background | Ozsancak Ugurlu A, Sidhom SS, Khodabandeh A, Ieong M, Mohr C, Lin DY, Buchwald I, Bahhady I, Wengryn J, Maheshwari V, Hill NS. Use and outcomes of noninvasive positive pressure ventilation in acute care hospitals in Massachusetts. Chest. 2014 May;145(5):964-971. doi: 10.1378/chest.13-1707. |