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This is a randomized controlled study to compare the incidence of gastric insufflation when using high-flow nasal oxygenation and facemask ventilation in pediatric patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| High-flow nasal oxygenation group (HFNO group) | Experimental |
| |
| Facemask ventilation group (MV group) | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HFNO group | Device | 100% oxygen supplied in proportion to body weight using the Optiflow THRIVETM system while maintaining jaw thrust. (0-12 kg; 2 L/kg/min, 13-15 kg; 30 L/min, 16-30 kg; 35 L/min, 31-50 kg; 40 L/min) |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of gastric insufflation | Incidence of gastric insufflation detected by gastric ultrasound (acoustic shadow phenomenon or comet-tail artifact in the antrum) or by epigastric auscultation (typical 'gurgling' or 'whoosh' sound) | From the start of anesthesia induction to 3 minutes after anesthesia induction |
| Measure | Description | Time Frame |
|---|---|---|
| Gastric insufflation detected by ultrasound | Presence of acoustic shadow phenomenon or comet-tail artifact detected by ultrasound | 3 minutes after anesthesia induction |
| Gastric insufflation detected by auscultation |
| Measure | Description | Time Frame |
|---|---|---|
| MAP | Mean arterial pressure | Every 1 minute during intervention (baseline, 1, 2, 3 min after induction) |
| HR | Heart rate | Every 1 minute during intervention (baseline, 1, 2, 3 min after induction) |
Inclusion Criteria:
Exclusion Criteria:
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|
| MV group | Device | Mask ventilation using the one-hand E-C clamp technique and oropharyngeal airway (fresh gas flow 3 l/min, 100% O2, tidal volume 8-10 ml/kg, respiratory rate 20/min, I:E ratio 1:2, pop-off valve 13 cmH2O). |
|
Presence of 'gurgling' or 'whoosh' sound detected by auscultation of the epigastrium.
| From the start of anesthesia induction to 3 minutes after anesthesia induction |
| gastric antrum longitudinal diameter (D1) | gastric antrum longitudinal diameter (D1) measured by ultrasound | 3 minutes after anesthesia induction |
| gastric antrum anteroposterior diameter (D2) | gastric antrum anteroposterior diameter (D2) measured by ultrasound | 3 minutes after anesthesia induction |
| gastric antral cross-sectional area (CSA) | gastric antral cross-sectional area (CSA) measured by ultrasound (CSA = (D1 Ⅹ D2 Ⅹ π)/4) | 3 minutes after anesthesia induction |
| SpO2 | Peripheral oxygen saturation | Every 1 minute during intervention (baseline, 1, 2, 3 min after induction) |
| TV | Tidal volume in MV group | Every 1 minute during intervention (1, 2, 3 min after induction) |
| PIP | Peak airway pressure in MV group | Every 1 minute during intervention (1, 2, 3 min after induction) |
| ETCO2 | End tidal CO2 in MV group | Every 1 minute during intervention (1, 2, 3 min after induction) and just after intubation |
| Lowest SpO2 | Lowest peripheral oxygen saturation during intervention | From the start of anesthesia induction to completion of tracheal intubation |