Tracheal Intubation
Conditions
Keywords
pediatrics, fiberoptic intubation, oral intubation, nasal intubation, children under the age of 2
Brief summary
There are two routes in which a fiberoptic intubation can be performed - oral and nasal. In general, nasal intubation by any conventional method may be the preferred choice for certain procedures such as intra-oral surgeries, or for anatomical reasons such as limited mouth opening. If nasal intubation is not indicated or preferred, then oral intubation is usually performed. This study is looking to explore whether or not the nasal route significantly improves the ease and time for successful fiberoptic intubation compared to the oral route in children less than or equal to 2 years of age. This study will also examine if operator experience influence time to tracheal intubation with either route? The investigators hypothesize that the nasal route of fiberoptic intubation will be faster than the oral route, for both the trainee and the expert, and that there will be minimal differences between experts and trainees with nasal fiberoptic intubation.
Detailed description
The goal of this prospective randomized study is to compare the effect of nasal fiberoptic intubation versus oral fiberoptic intubation in children less than 2 years of age. Other factors that will be assesed include operator experience, the ease and time for fiberoptic grade of laryngeal view, time for fiberoptic tracheal intubation, and complications. This study is looking to explore whether or not the nasal route significantly improves the ease and time for successful fiberoptic intubation compared to the oral route in children less than or equal to 2 years of age. While also asking, will operator experience influence time to tracheal intubation with either route? The investigators hypothesize that the nasal route fiberoptic intubation will be faster than the oral route, for both the trainee and the expert, and that there will be minimal differences between experts and trainees with nasal fiberoptic intubation.
Interventions
OTHERFiberoptic Intubation through the nasal route
OTHERFiberoptic intubation through the oral route
Sponsors
Ann & Robert H Lurie Children's Hospital of Chicago
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Days to 2 Years
Healthy volunteers
Yes
Inclusion criteria
* Healthy children ASA I to III * Patients less than or equal to 2 years of age * Patients with scheduled surgeries in which endotracheal intubation is part of their general anesthetic plan
Exclusion criteria
* Children with ASA IV or V * Children with active respiratory infection, pulmonary disease, a known history of difficult mask ventilation, high suspicion of difficult airway (secondary to congenital syndromes for example), and significant airway abnormalities
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time to fiberoptic intubation | From disconnection of oxygen to reconnection of oxygen during tracheal intubation |
Other
| Measure | Time frame | Description |
|---|---|---|
| Time to first glottic view | during tracheal intubation | This will be measuring the time it takes the anesthesiologist to have the first glottic view. |
| Time to carinal view | during tracheal intubation | This is the time it will take the anesthesiologist to the first carinal view. |
| Time to successful intubation | during tracheal intubation | This will measure the entire time period it takes for the ansthesiologist to intubate the patient. |
| Complications | From the beginning to the end of intubation, and after the surgery up to 24 hours post-op | Complications will be recorded and defined as follows: * laryngospasm: clinical evidence of inability to ventilate * bronchospasm: bilaterally inspiratory and expiratory wheezing along with potential desaturations and changes in capnogram morphology * desaturation: SpO2 (blood oxygen saturation) below 90% at any time during the case |
Countries
United States
Outcome results
None listed