Hypoxemia
Conditions
Keywords
hypoxemia, oxygen concentration, atelectasis
Brief summary
Before extubation during the anesthesia recovery period, 100% oxygen is routinely inhaled to increase the oxygen reserves, maximizing the time window for anesthesiologists to adjust strategies when they encounter hypoxemia after extubation. However, even inhaling a short period of pure oxygen can cause absorptive atelectasis, and may even impair the effectiveness of intraoperative protective ventilation measures continuing to post-operative period. The purpose of this study is to determine whether 30% oxygen before extubation after abdominal surgery could reduce hypoxemia incidence after extubation during the recovery period or not, compared to 100% oxygen. 590 patients scheduled to abdominal surgeries, will be randomly assigned to receive 30% or 100% oxygen concentration from the end of surgery to extubation after general anesthesia in the post-anesthesia care unit. The incidence of hypoxemia (SpO2 \< 90%) from extubation to leaving the post-anesthesia care unit (PACU) is the primary outcome.
Interventions
OTHER100% oxygen concentration inhaled
Oxygen concentration inhaled from the end of surgery to tracheal extubation after general anesthesia in the recovery period is 100%.
OTHER30% oxygen concentration inhaled
Oxygen concentration inhaled from the end of surgery to tracheal extubation after general anesthesia in the recovery period is 30%.
Sponsors
Sixth Affiliated Hospital, Sun Yat-sen University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 18-65 years old, scheduled for elective abdominal surgery in general anesthesia with endotracheal intubation; ASA I-III grade; cardiac function 1-2 grade; 18 kg/m2 \< BMI \< 28 kg/m2; Preoperative SpO2 ≥ 94% without oxygen supplementation at rest; pre-anesthesia assessment shows no difficult airway, no difficulty with mask ventilation, no difficulty in intubation during tracheal insertion, and no difficulty in extubation as expected.
Exclusion criteria
* Respiratory infection recently, or atelectasis, inflammation, fibrosis, or pleural effusion by chest CT preoperatively. History thoracic surgery and fractures of the sternum or ribs, chest deformity, difficulty in raising both upper limbs, or scoliosis. High risk of reflux aspiration. Severe hepatic or renal dysfunction (e.g., Child-Pugh class C liver disease, or requiring dialysis). Limb movement disorders. Mask ventilation or intubation difficulty during anesthesia induction. Occurrence of severe allergy, massive bleeding, suspected pulmonary embolism, pulmonary edema, myocardial injury, or cardiopulmonary arrest during surgery. Currently participating in other clinical studies, which may have an impact on this study. Inability to cooperate well for mental disorder, or hypophrenia.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of hypoxemia | At the day of surgery from tracheal extubation to leaving the post-anesthesia care unit |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of severe hypoxemia | At the day of surgery from tracheal extubation to leaving the post-anesthesia care unit | — |
| Arterial partial pressure of oxygen (PaO2) | At the day of surgery after tracheal extubation in the post-anesthesia care unit | — |
| Score of lung ultrasound | At the day of surgery after tracheal extubation in the post-anesthesia care unit | The score of lung ultrasound ranges from 0 to 36, and a higher score means a worse ventilation. |
| Area of atelectasis shown on chest CT | At the day of surgery after tracheal extubation | — |
| Incidence of post operative pulmonary-related complications | Within 7 days after surgery | — |
| Length of postoperative stay | At hospital discharge | — |
| Number of patients return to the hospital after discharge | 30 days after surgery | — |
| Number of deaths | 30 days after surgery | — |
| Number of patients with important organ disfunction after surgery, including arrhythmia, acute myocardial injury, heart failure, renal function injury, liver function injury, and cerebrovascular accident. | 30 days after surgery | — |
| Number of patients unplanned transfers to the ICU | 30 days after surgery | — |
Countries
China
Contacts
Primary ContactSanqing Jin
Backup ContactYanna Pi
Outcome results
None listed