Airway Management, Laryngeal Diseases
Conditions
Keywords
Flow Controlled Ventilation, Volume Controlled Ventilation, Suspension Laryngoscopy, Airway Manegement, Respiratory Mechanics
Brief summary
Suspension laryngoscopy presents significant challenges for airway management due to the need to maintain adequate ventilation while providing optimal surgical exposure. Flow-controlled ventilation (FCV) is a novel ventilation mode that delivers constant inspiratory and expiratory flow using a narrow-lumen, cuffed endotracheal tube, potentially improving ventilation efficiency in shared-airway surgeries. This prospective observational study aims to compare flow-controlled ventilation and conventional volume-controlled ventilation in patients undergoing elective suspension laryngoscopy. Respiratory mechanics, hemodynamic parameters, perioperative pulmonary function, and procedure-related complications will be evaluated to assess the feasibility and clinical performance of FCV in this surgical setting.
Detailed description
Suspension laryngoscopy is a shared-airway surgical procedure that requires optimal visualization of the operative field while maintaining adequate ventilation and oxygenation. Conventional ventilation strategies may be associated with increased airway pressures and limited surgical exposure due to the use of standard endotracheal tubes. Flow-controlled ventilation (FCV) is a ventilation mode characterized by constant inspiratory and expiratory flow, which may offer advantages in procedures requiring a narrow airway device. This prospective, non-randomized, observational comparative study evaluates adult patients undergoing elective suspension laryngoscopy. The choice of ventilation strategy-flow-controlled ventilation or conventional volume-controlled ventilation-was based on the attending anesthesiologist's clinical preference, reflecting routine clinical practice. All patients provided written informed consent prior to participation. In both groups, standardized anesthetic management was applied, and ventilation parameters were adjusted to maintain normocapnia and adequate oxygenation. Intraoperative respiratory mechanics, including airway pressures and lung compliance, were recorded at predefined intervals. Hemodynamic parameters were monitored throughout the procedure. Pulmonary function tests were performed preoperatively and postoperatively using a portable spirometry device. Perioperative complications were documented. The primary objective of this study is to compare intraoperative respiratory mechanics between flow-controlled and volume-controlled ventilation during suspension laryngoscopy. Secondary objectives include the assessment of perioperative hemodynamic parameters, changes in pulmonary function, and procedure-related complications.
Interventions
None listed
Sponsors
Ankara Training and Research Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
- Adult patients aged 18 to 65 years * American Society of Anesthesiologists (ASA) physical status I-III * Scheduled for elective suspension laryngoscopy under general anesthesia * Body mass index between 18 and 40 kg/m² * Provision of written informed consent
Exclusion criteria
- Severe cardiac, pulmonary, hepatic, or renal disease * Inability to cooperate with pulmonary function testing * Intraoperative hemodynamic instability or oxygen desaturation (SpO₂ \<92%) * Requirement for tracheostomy during the procedure
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peak airway pressure | During surgery with 10 minute intervals | Intraoperative peak airway pressure (cmH2O) measured at predefined time intervals during suspension laryngoscopy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory system compliance | Intraoperative period during suspension laryngoscopy with 10 minute intervals. | Respiratory system compliance (mL/cmH2O) measured at predefined intraoperative time intervals. |
| End tidal carbondioxide | Intraoperative period during suspension laryngoscopy with 10 minute intervals | End-tidal carbon dioxide levels (mmHg) measured during suspension laryngoscopy. |
| Peripheral oxygen saturation | Intraoperative period during suspension laryngoscopy with 10 minute intervals. | Peripheral oxygen saturation (%) measured during suspension laryngoscopy. |
| Forced expiratory volume in one second | 30 minutes before surgery and 12 hours after surgery | Preoperative and postoperative forced expiratory volume in one second (liter) measured using pulmonary function testing. |
| Forced vital capacity | 30 minutes before surgery and 12 hours after surgery | Preoperative and postoperative forced vital capacity (liter) measured using pulmonary function testing. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORSalih Birkan ARI, M.D.
Ankara Trainig and Research Hospital
Outcome results
None listed