Ventilation Therapy; Complications, Trachea
Conditions
Keywords
Flow Controlled Ventilation,, Tritube,, Volume Controlled Ventilation,
Brief summary
Ventilation through the small endotracheal tube is not an uncommon situation. The indications for it differ from elective upper airway surgery to emergency ventilation through needle cricothyrotomy. Conventionally, ventilation through small endotracheal tubes has been challenging by jet ventilation with subsequent risk of barotrauma and inadequate gas exchange. Expiration during jet ventilation occurs passively.
Detailed description
Upper airway endoscopy (micro laryngoscopy (MLS), pan endoscopy) is a minor upper airway procedure needing short duration general anesthesia, small calibrate endotracheal tube and manipulation of the airway. Because of airway manipulation and the surgery involves the airway, which is being shared with the anesthesiologist, there is a risk of interruption of ventilation, oxygenation and loss of airway in addition to inherent complications of surgery. Methods: After the patients will receive information about the study and informed consent will be taken. The patients will be randomized. In the control group, (group A) ventilation will be performed according to the routine big endotracheal tube. In the treatment group (group B), the ultra-thin ventilation tube will be placed using laryngoscopy. All other treatment will be unchanged. Data collection will be started 5 min after the initiation of the study. Demographic data, Past medical history, and examinations data will be collected after acceptance of the patient to be enrolled into the study and other ventilation parameters will be collected 5 min after the start of the the study which is Skin incision Primary endpoint is; to evaluate whether the Flow Controlled Ventilation (FCV) can also achieve adequate oxygenation and ventilation through small tube or not.
Interventions
Mechanically ventilated using Flow Controlled Ventilation (FCV)
Sponsors
Hamad Medical Corporation
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adult population of both sex (ASA I, II). * Between18-65 years of age. * Patients for the upper airway. * Patients need intubation/invasive mechanical ventilation.
Exclusion criteria
* ASA \>II * Advanced Respiratory disease. * Advanced cardiovascular disease. * Smokers. * Pregnancy. * Recent upper airway trauma. * Age less than 18 years or more than 65 years. * Patients BMI of more than 35 * Refuse to sign the consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Measurement of dynamic chest wall compliance (mL/mbar) | During study time intra-operatively | Dynamic chest wall compliance changes due to Flow Controlled Ventilation (FCV) in comparison to routine Volume Controlled Ventilation(VCV) |
| Airway Resistance (mbar*s/L) | During procedure time and intra-operatively | This measures the airway resistance changes due to Flow Controlled Ventilation (FCV) in comparison to the traditional Volume Controlled Ventilation(VCV) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative sore throat according the Visual Analogue Scale (VAS) | After surgical procedure (2 and 24) hours. | Postoperative sore throat after 2 and 24 hours using the VAS score (0-10). (Zero=no pain and 10 = for the most sever pain. |
| Oxygen concentration (SPaO2)and tension(PaO2) in the blood (% and mmHg respectively) | Intra-operatively during procedure time | This will measure the patient oxygenation during intervention in both studied groups and using the arterial blood gases |
| Surgeon satisfaction instance scale (1-5) | During surgical procedure | the Surgeon satisfaction score according the space free for the surgery which range from (1= poor, 2= medium, 3= good, 4= very good, and 5= excellent). |
| Kink of the small size tube (Tritube) (Yes/No) | During surgical procedure | Kink of the small (Tritube) (using machine alarms for obstruction and visual inspection) so will be (yes) for partial or complete obstruction and (no) for the absence of obstruction) |
| Carbon dioxide in the blood (PaCO2) and the trachea (ECO2) mmHg. | During surgical procedure intra-operatively | This measures the patient ventilation during intervention in both studied groups using capnogram and arterial blood gases |
Countries
Qatar
Contacts
Primary ContactNabil A. Shallik, M.D.
Outcome results
None listed