NCT06736197

An Algorithmic Approach to Preoxygenation

An Algorithmic Approach to Preoxygenation: Stepwise Addition of Pressure Support and Positive End-expiratory Pressure When Tidal Volume Breathing is Inadequate. A Randomised Controlled Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 378 (actual)
• Sponsor: Pamukkale University · Academic / Other
• Sex: All
• Age: 18 Years – 65 Years
• Healthy volunteers: Not accepted

Summary

The aim of this randomized controlled trial is to evaluate an algorithmic approach to gradually adding pressure-supported ventilation and end-tidal positive pressure when conventional tidal volume breathing is insufficient for adequate preoxygenation. The main question it aims to answer is: * Will the proportion of patients receiving preoxygenation increase? * Will the duration of preoxygenation decrease? Participants will; * 200 patients who were planned to undergo general anesthesia for elective surgeries * aged between 18 and 65 years * ASA 1-2 physical status * ETO2 \<90% at the end of the 3rd minute with spontaneous tidal volume breathing

Detailed description

The patients were randomly assigned to one of two groups (Group TVB and Group PSV) according to a computer-generated randomisation table. In the patients included in Group TVB, the tidal volume breathing was maintained for a further two minutes. Group PSV received inspiratory pressure support of 6 cm H2O for +1 min. At the end of four minutes, patients whose ETO₂ value had not reached a minimum of 90% were randomly divided once more into two groups. One group continued with PSV, while the other was administered 4 cm H₂O PEEP in addition to PSV (Group PSV+PEEP). When adequate preoxygenation was achieved, the duration of preoxygenation, SpO2, end-tidal carbon dioxide (ETCO2), arterial blood pressures and heart rate values were recorded. Any adverse effects such as discomfort or gastric distension were noted.

Conditions

• Preoxygenation
• Anaesthesia Induction
• Non-invasive Positive Pressure Ventilation

Interventions

Type	Name	Description
PROCEDURE	Group TVB	Patients who could not reach ETO2 value 90 with tidal volume breathing for 3 min were included in Group TVB tidal volume breathing was continued for 2 min.
PROCEDURE	Group PSV	Preoxygenation was continued by providing 6cmH2O pressure support to the patients included in this group.
PROCEDURE	Group PSV+PEEP	At the 4th minute, preoxygenation was continued by adding 4 cmH2O positive end-expiratory pressure to the same 6 cmH2O pressure support for 1 min in patients whose end-tidal O2 value still reached 90% and who were included in this group.

Timeline

• Start date: 2020-03-01
• Primary completion: 2021-03-01
• Completion: 2021-06-01
• First posted: 2024-12-16
• Last updated: 2024-12-16

Locations

1 site across 1 country: Turkey (Türkiye)