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| Name | Class |
|---|---|
| National Evidence-Based Healthcare Collaborating Agency | OTHER_GOV |
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This is a prospective randomized controlled trial comparing high flow nasal cannula and buccal oxygenation as method of oxygenation during apnea in children.
This is a prospective randomized controlled trial comparing two oxygenation methods for prolongation of apnea time in children aged 0 to 10 years old.
This study measures time for the pulse oximetry drop from 100% to 92% after oxygenation with 100% oxygen, applying high flow nasal cannula or buccal oxygen insufflation via an oral Ring-Adair-Elwyn endotracheal tube connected to oxygen.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| High flow | Experimental | Application of high flow nasal cannula during apnea |
|
| Buccal | Active Comparator | Application of buccal oxygenation during apnea |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High flow nasal cannula | Device | Oxygen supplement via high flow nasal cannula at a rate of 2 liters/kg/min |
|
| Measure | Description | Time Frame |
|---|---|---|
| Apnea success rate | Proportion of patients that succeed in prolongation of apnea time while maintaining pulse oximetry > 92% | From start of apnea to drop of pulse oximetry to 92%, up to 520 seconds |
| Measure | Description | Time Frame |
|---|---|---|
| Apnea time | Time elapsed from start of apnea to resume of bag-mask ventilation | From start of apnea to drop of pulse oximetry to 92%, up to 520 seconds |
| End-tidal carbon dioxide | End-tidal carbon dioxide partial pressure of first resumed breath after apnea |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jin-Tae Kim, M.D., Ph.D. | Seoul National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | 03080 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26705976 | Background | Fiadjoe JE, Nishisaki A, Jagannathan N, Hunyady AI, Greenberg RS, Reynolds PI, Matuszczak ME, Rehman MA, Polaner DM, Szmuk P, Nadkarni VM, McGowan FX Jr, Litman RS, Kovatsis PG. Airway management complications in children with difficult tracheal intubation from the Pediatric Difficult Intubation (PeDI) registry: a prospective cohort analysis. Lancet Respir Med. 2016 Jan;4(1):37-48. doi: 10.1016/S2213-2600(15)00508-1. Epub 2015 Dec 17. | |
| 8827740 |
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| ID | Term |
|---|---|
| D001049 | Apnea |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
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Prospective randomized controlled trial
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| Buccal oxygenation | Device | Oxygen supplement intra-orally via oral Ring-Adair-Elwyn endotracheal tube connected to oxygen at a rate of 0.5 liters/kg/min |
|
| After resuming of bag-mask ventilation, up to 30 seconds |
| Minimal pulse oximetry | Lowest value of pulse oximetry after resume of bag-mask ventilation | After resuming of bag-mask ventilation, up to 60 seconds |
| Time to pulse oximetry of 100 percent | Time elapsed from resume of bag-mask ventilation to regain of 100 percent in the pulse oximetry value | After resuming of bag-mask ventilation, up to 300 seconds |
| Electrocardiogram | Appearance of any arrhythmia or prolonged QT interval measured throughout the study | From start of study to end of study, up to 20 min |
| Mean blood pressure | Mean non-invasive blood pressure measured throughout the study | From start of study to end of study, up to 20 min |
| Pulse oximetry | Pulse oximetry measured throughout the study | From start of study to end of study, up to 20 min |
| Oxygen reserve index | Oxygen reserve index measured throughout the study | From start of study to end of study, up to 20 min |
| Transcutaneous carbon dioxide | Transcutaneous carbon dioxide level measured throughout the study | From start of study to end of study, up to 20 min |
| Heart rate | Heart rate measured throughout the study | From start of study to end of study, up to 20 min |
| Background |
| Frei FJ, Ummenhofer W. Difficult intubation in paediatrics. Paediatr Anaesth. 1996;6(4):251-63. doi: 10.1111/j.1460-9592.1996.tb00447.x. No abstract available. |
| 12412683 | Background | Schibler A, Hall GL, Businger F, Reinmann B, Wildhaber JH, Cernelc M, Frey U. Measurement of lung volume and ventilation distribution with an ultrasonic flow meter in healthy infants. Eur Respir J. 2002 Oct;20(4):912-8. doi: 10.1183/09031936.02.00226002. |
| 15449573 | Background | King W, Petrillo T, Pettignano R. Enteral nutrition and cardiovascular medications in the pediatric intensive care unit. JPEN J Parenter Enteral Nutr. 2004 Sep-Oct;28(5):334-8. doi: 10.1177/0148607104028005334. |
| 19672959 | Background | Schibler A, Yuill M, Parsley C, Pham T, Gilshenan K, Dakin C. Regional ventilation distribution in non-sedated spontaneously breathing newborns and adults is not different. Pediatr Pulmonol. 2009 Sep;44(9):851-8. doi: 10.1002/ppul.21000. |
| 12780980 | Background | Schibler A, Henning R. Positive end-expiratory pressure and ventilation inhomogeneity in mechanically ventilated children. Pediatr Crit Care Med. 2002 Apr;3(2):124-128. doi: 10.1097/00130478-200204000-00006. |
| 9356095 | Background | Erb T, Marsch SC, Hampl KF, Frei FJ. Teaching the use of fiberoptic intubation for children older than two years of age. Anesth Analg. 1997 Nov;85(5):1037-41. doi: 10.1097/00000539-199711000-00013. |
| 28035669 | Background | Mir F, Patel A, Iqbal R, Cecconi M, Nouraei SA. A randomised controlled trial comparing transnasal humidified rapid insufflation ventilatory exchange (THRIVE) pre-oxygenation with facemask pre-oxygenation in patients undergoing rapid sequence induction of anaesthesia. Anaesthesia. 2017 Apr;72(4):439-443. doi: 10.1111/anae.13799. Epub 2016 Dec 30. |
| 29330853 | Background | Lodenius A, Piehl J, Ostlund A, Ullman J, Jonsson Fagerlund M. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) vs. facemask breathing pre-oxygenation for rapid sequence induction in adults: a prospective randomised non-blinded clinical trial. Anaesthesia. 2018 May;73(5):564-571. doi: 10.1111/anae.14215. Epub 2018 Jan 13. |
| 28100527 | Background | Humphreys S, Lee-Archer P, Reyne G, Long D, Williams T, Schibler A. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) in children: a randomized controlled trial. Br J Anaesth. 2017 Feb;118(2):232-238. doi: 10.1093/bja/aew401. |
| 30784037 | Background | Lyons C, Callaghan M. Uses and mechanisms of apnoeic oxygenation: a narrative review. Anaesthesia. 2019 Apr;74(4):497-507. doi: 10.1111/anae.14565. Epub 2019 Feb 19. |
| 15871753 | Background | Wettstein RB, Shelledy DC, Peters JI. Delivered oxygen concentrations using low-flow and high-flow nasal cannulas. Respir Care. 2005 May;50(5):604-9. |
| 19846404 | Background | Parke R, McGuinness S, Eccleston M. Nasal high-flow therapy delivers low level positive airway pressure. Br J Anaesth. 2009 Dec;103(6):886-90. doi: 10.1093/bja/aep280. Epub 2009 Oct 20. |
| 27655276 | Background | Heard A, Toner AJ, Evans JR, Aranda Palacios AM, Lauer S. Apneic Oxygenation During Prolonged Laryngoscopy in Obese Patients: A Randomized, Controlled Trial of Buccal RAE Tube Oxygen Administration. Anesth Analg. 2017 Apr;124(4):1162-1167. doi: 10.1213/ANE.0000000000001564. |
| D013568 | Pathological Conditions, Signs and Symptoms |