Air Test, Atelectases, Resorption, Atelectasis, Atelectasis Without Respiratory Distress Syndrome, Lung Collapse, Lung Diseases, Pediatric Disorder
Conditions
Keywords
air test, atelectasis, pediatric, non-invasive, lung collapse
Brief summary
HYPOTHESIS: During anesthetic pre-oxygenation with high FiO2, pulmonary atelectasis occur, especially in patients \< 6 years old, where FRC and pulmonary closing volume may overlap. New borns and children \<1 year old are especially vulnerable. OBJECTIVES: 1. Validate air test as a individualized and non-invasive diagnostic method of clinically significant atelectasis in pediatrics. 2. Determine what other factors contribute to atelectasis development in pediatrics METHODS: 30 pediatric patients will be studied with ages ranged between 45 postconceptional weeks and16 years old. Baseline SpO2 and lung ultrasound will be performed for each patient upon arrival at the operating theatre before preoxygenation with FiO2 of 1.0 SpO2 will be measured 15 min after intubation during a 5 min long air test trial (FiO2 0.25). lung collapse will be verified by lung ultrasound at the end of the 15 min trial. Lung collapse will be eventually granted upon lung US verification by a blind researcher.
Interventions
DIAGNOSTIC_TESTAir test
Patients will breathe 0.21 \< FiO2 \< 0.25 during 5 min and have a lung ultrasound perfomed at the end of the 5 min trial.
Sponsors
Hospital Universitario La Princesa
Hospital Privado de Comunidad
Hospital Universitario La Paz
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Masking description
Lung Collapse will be diagnosed by a blind researcher that does not know the air test results
Eligibility
Sex/Gender
ALL
Age
5 Weeks to 16 Years
Healthy volunteers
Yes
Inclusion criteria
* General anesthesia * Perioperative risk classification (ASA) I, II, III * Newborns (postconceptional age\> 45 weeks) to 16 years * Need for oral / nasotracheal intubation
Exclusion criteria
* ASA \> III * Basal SpO2 \< 97% on air in supine position * Preoperative need for oxygen therapy and / or high-flow nasal cannulas * Expected Difficult airway * Presence of craniofacial disorders that may compromise ventilation * Hemodynamic instability and / or need for inotropics * History of untreated heart disease * Presence or history of pneumothorax * Presence of untreated congenital pulmonary disorders * Refusal to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Atelectasis incidence | 5 minutes | Assess incidence of SpO2 \< 97% 15 minutes after anesthesia induction during a 5 minutes long air test (FiO2 \< 0.25). |
| Accuracy of Pediatric Air test trial | 5 minutes | Assess incidence of lung collapse (hence atelectasis incidence) 15 minutes after anesthesia induction using an air test (FiO2 \< 0.25). Collapse blind validation using lung US |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Atelectasis risk factors assessment | 5 minutes | Determine if there occurs higher atelectasis incidence depending on age, sex, medical records, body weight index or type of surgery |
| Atelectasis severity | 5 minutes | Determine if there is any correlation between SpO2 values during air test and lung collapse, graded upon a validated severity lung collapse image score |
Countries
Argentina, Spain
Outcome results
None listed