Hemodynamic Effects of Apnoeic Oxygenation With High-flow Nasal Oxygen in Adults Undergoing Laryngeal Surgery - a Randomised Study

Status: Recruiting
Location: See location...
Intervention Type: Other, Device
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

During apnoeic oxygenation there is a continuous raise in carbon dioxide with subsequent respiratory acidosis. The hypercapnia and respiratory acidosis have several dose-related effects on both the systemic and the pulmonary circulation and the heart that ultimately, if unrecognised, can result in cardiovascular collapse and fatal arrhythmias. In our knowledge, no studies have investigated the haemodynamic effects of apnoeic oxygenation with HFNO. The general purpose of this project is to investigate haemodynamic alternations during apnoeic oxygenation with HFNO compared to mechanical ventilation in relatively healthy patients under general anaesthesia during laryngeal surgery.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 110
Healthy Volunteers: f
View:

• Adult, ≥18 years old

• ASA 1-2

• BMI \< 30

• Planned for elective laryngeal surgery

Locations
Other Locations
Sweden
Karolinska Universitetssjukhuset Huddinge
RECRUITING
Stockholm
Contact Information
Primary
Malin Jonsson Fagerlund
malin.jonsson-fagerlund@regionstockholm.se
+46 8 1237000
Time Frame
Start Date: 2024-03-25
Estimated Completion Date: 2026-03-25
Participants
Target number of participants: 20
Treatments
Experimental: Apnoeic oxygenation with High-flow nasal oxygen
In the apnoeic oxygenation group the HFNO is used for pre-oxygenation,100 % O2, 40 L/min during 3 min. Thereafter, anaesthesia is induced by intravenous Propofol and Remifentanil. Rocuronium for full neuromuscular blockade is administered and a jaw thrust is used to keep an open airway. The airway will be kept patent throughout the procedure using a suspension laryngoscope, placed by the ENT surgeon. During apnoea oxygen will be increased to 70 L/min, 100% O2. Apnoea will be discontinued if any of the criteria SpO2 \< 90%, PaCO2 \>11 kPa, pH \<7.15 or arrhythmias with haemodynamic effects occur.
Active_comparator: Mechanical ventilation
In the mechanical ventilation group pre-oxygenation is performed by a tight-fitting facemask, 100 % O2, for three minutes. After anaesthesia induction and full neuromuscular blockade, tracheal intubation is performed and mechanical ventilation is started.
Related Therapeutic Areas
Sponsors
Collaborators: Karolinska Institutet
Leads: Region Stockholm

This content was sourced from clinicaltrials.gov