Gastric insufflation and perioperative aspiration risk during pediatric anesthesia induction
Conditions
Interventions
HFNC group:During anesthesia induction, high-flow nasal cannula oxygenation (HFNC) will be used without face-mask assisted ventilation. The flow rate will be set according to body weight: 2 L/kg/min f
and 2 L/kg/min for children weighing >15–30 kg, up to 30 L/min. FiO2 will be set at 1.0 with heated humidification. Rescue procedures will be initiated immediately if hypoxemia or inadequate ventilati
Face-mask positive pressure ventilation group:Face-mask positive pressure ventilation will be applied during anesthesia induction. FiO2 will be set at 1.0. Manual positive-pressure face-mask ventilati
Sponsors
Huadu District People’s Hospital of Guangzhou
Eligibility
Sex/Gender
All
Age
2 Years to 7 Years
Inclusion criteria
Inclusion criteria: 1. Children scheduled for elective surgery under general anesthesia requiring endotracheal intubation; 2. ASA physical status I–II; 3. Age 2 to =2 h, milk/formula/light meal >=6 h, and solid food >=8 h; 5. Feasible to complete gastric antral ultrasound assessment in both the supine and right lateral decubitus positions during anesthesia induction; 6. Written informed consent obtained from the legal guardian.
Exclusion criteria
Exclusion criteria: 1. Known or suspected delayed gastric emptying, gastrointestinal obstruction, or conditions significantly increasing aspiration risk, such as severe gastroesophageal reflux, pyloric obstruction/stenosis, or gastrointestinal bleeding; 2. Emergency surgery or non-fasting/non-compliance with fasting requirements; 3. Anticipated difficult airway or need for rapid sequence induction (RSI); 4. Severe cardiopulmonary disease or baseline SpO2 <95% on room air or routine oxygen supplementation; 5. Inability to tolerate HFNC or face-mask ventilation, such as severe nasal obstruction/deformity or recent nasal surgery, or deemed unsuitable by the investigator; 6. Failure to obtain interpretable gastric ultrasound images in the supine or right lateral decubitus position, such as poor visualization of the antrum due to bowel gas or positioning limitations; 7. Refusal or withdrawal of consent by the legal guardian.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in gastric antral cross-sectional area in the right lateral decubitus position (?CSAa-RLD); | — |
Secondary
| Measure | Time frame |
|---|---|
| Change in gastric antral cross-sectional area in the supine position (?CSAa-supine);Change in gastric volume grade;Predicted gastric volume and body weight-adjusted predicted gastric volume;Hypoxemia and need for rescue intervention;Incidence of regurgitation/aspiration;Incidence of postoperative nasal dryness, epistaxis, and postoperative nausea and vomiting; | — |
Countries
China
Contacts
Public ContactNing Shen
Huadu District People’s Hospital of Guangzhou
Outcome results
None listed