Bradycardia, Hypoxemia
Conditions
Keywords
CPR, flexible bronchoscope, resuscitation, ventilation
Brief summary
The nasopharyngeal oxygen (NPO) with Nose-close (NC) and Abdomen-compression (AC) technique may use for support or rescue asphyxiated infants during Flexible bronchoscopy.
Detailed description
OBJECTIVES: To evaluate the efficacy of a novel cardiopulmonary resuscitation (CPR) technique-nasopharyngeal oxygenation with nose-close and abdomen-compression (NPO-NC-AC)-in small infants during flexible bronchoscopy (FB). METHODS: Infants with body weight (BW) \<5.0 kg and receiving nasal diagnostic or interventional FB (dFB, iFB) were enrolled. Under NPO (0.5 L/kg/min), when infant's heart rate (HR) \<80 beats/min or oxygen saturation (SpO2) \<85% for more than 10 seconds, rescue NC-AC was initiated. It was performed by (1) increased NPO flow to 0.5-1.0 L/kg/min; (2) NC 1 second for inspiration; and (3) AC 1 second for expiration with simultaneously released nostrils. Repeat doing steps (2) and (3) at a rate of 30 cycles/min until HR, SpO2, and blood pressure (BP) returned to normal. Cardiopulmonary parameters were monitored and analyzed.
Interventions
OTHERNPO with Nose-close and Abdomen-compression
Infants with body weight (BW) \<5.0 kg and receiving nasal diagnostic or interventional FB were enrolled. Under NPO (0.5 L/kg/min), when infant's heart rate (HR) \<80 beats/min or oxygen saturation (SpO2) \<85% for more than 10 seconds, rescue NC-AC was initiated. It was performed by (1) increased NPO flow to 0.5-1.0 L/kg/min; (2) NC 1 second for inspiration; and (3) AC 1 second for expiration with simultaneously released nostrils. Repeat doing steps (2) and (3) at a rate of 30 cycles/min until HR, SpO2, and blood pressure (BP) returned to normal.
Sponsors
Cho-yu Chan, MD
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
No minimum to 20 Years
Healthy volunteers
No
Inclusion criteria
* body weight (BW) less than 5.0 kg; * receiving nasal approach flexible bronchoscopy.
Exclusion criteria
* cannot nasal approach flexible bronchoscopy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate (beat/min) | Participants will continually monitoring by EKG for 2 days after the procedure. | During and after this FB procedure, vital signs are continually monitoring. When the heart rate (HR) \<80 beat/min (measured by continuouse wave and digit form of EKG monitor) and lasting \>10 seconds. Immediately rescued with rhythmic NC-AC. If the heart rate did not reach to its acceptable level (\>80 beat/min) within 2 minutes, then traditional CPR procedures involving bag-mask ventilation, ET intubation, Ambu bag ventilation or even chest compressions were substituted. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Oxygen saturation by pulse oximetry | Participants will continually monitoring by pulse oximeter for 2 days after the procedure. | During FB procedure, vital signs are continually monitoring. When the oxygen saturation \<85% (or more than 10% below the original baseline in already cyanotic infant)by pulse oximeter and lasting \>10 seconds. Immediately rescued with rhythmic NC-AC. If the oxygen saturation did not reach to its acceptable level (\>85%) within 2 minutes, then traditional CPR procedures involving bag-mask ventilation, ET intubation, Ambu bag ventilation or even chest compressions were substituted. |
| Mean blood pressure (mmHg) | Participants will continually monitoring by sphygmomanometer for 2 days after the procedure. | During and after the FB procedure, vital signs are continually monitoring. When the mean blood pressure \<50mmHg (measured by continuous non-invasive sphygmomanometer every 5 minutes and one hour, respectively) and lasting morethan one hour. Immediately rescued with rhythmic NC-AC. If the mean BP did not reach to its acceptable level (\>50mmHg) within 10 minutes, then traditional CPR procedures involving bag-mask ventilation, ET intubation, Ambu bag ventilation or even chest compressions were substituted. |
Countries
Taiwan
Outcome results
None listed