NCT07480031

Determination of the Optimal Inspiratory Pressure to Decrease Incidence of Gastric Insufflation With Adequate Ventilation During Facemask Ventilation in Morbidly Obese Patients

Ultrasound-Guided Optimization of Inspiratory Pressure During Facemask Ventilation in Morbidly Obese Patients to Prevent Gastric Insufflation: A Randomized Clinical Trial

• Status: Not Yet Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 144 (estimated)
• Sponsor: Benha University · Academic / Other
• Sex: All
• Age: 18 Years – 65 Years
• Healthy volunteers: Not accepted

Summary

The goal of this randomized clinical trial is to optimize the inspiratory pressure during facemask ventilation (FMV) in morbidly obese patients (BMI ≥40 kg/m²), to ensure adequate ventilation while minimizing the risk of gastric insufflation by real-time ultrasound guidance

Detailed description

Morbid obesity, defined as a body mass index (BMI) ≥ 40 kg/m², presents significant challenges during the management of the airway and ventilation under general anesthesia. One of the critical issues is the increased risk of gastric insufflation during facemask ventilation (FMV), which can lead to pulmonary aspiration, reduced lung compliance, and impaired oxygenation. Therefore, optimizing inspiratory pressure to ensure adequate ventilation while minimizing the risk of gastric insufflation is paramount in this population. Ultrasound imaging has emerged as a valuable, non-invasive tool for real-time assessment of gastric content and volume. Recent studies have demonstrated the utility of gastric ultrasonography in detecting gastric insufflation during positive pressure ventilation. By visualizing the antrum and measuring the cross-sectional area , anesthesiologists can identify even small volumes of air entering the stomach, which might not be clinically apparent.

Conditions

• Gastric Insufflation

Interventions

Type	Name	Description
DEVICE	"Ultrasound-Guided Optimization of Inspiratory Pressure During Facemask Ventilation"	Description: Group A will be subjected to an inspiratory pressure of 10 cmH₂O. A curvilinear ultrasound probe will be placed in the epigastric region to visualize the antrum. Baseline gastric ultrasound will be performed to confirm an empty stomach. During FMV, ultrasound images will be obtained at 30, 60, and 90 seconds. Gastric insufflation will be detected by the change in gastric cross-sectional area (ΔCSA).
DEVICE	"Ultrasound-Guided Optimization of Inspiratory Pressure During Facemask Ventilation"	Description: Group B will be subjected to an inspiratory pressure of 15 cmH₂O. A curvilinear ultrasound probe will be placed in the epigastric region to visualize the antrum. Baseline gastric ultrasound will be performed to confirm an empty stomach. During FMV, ultrasound images will be obtained at 30, 60, and 90 seconds. Gastric insufflation will be detected by the change in gastric cross-sectional area (ΔCSA).
DEVICE	"Ultrasound-Guided Optimization of Inspiratory Pressure During Facemask Ventilation"	Description: Group C will be subjected to an inspiratory pressure of 20 cmH₂O. A curvilinear ultrasound probe will be placed in the epigastric region to visualize the antrum. Baseline gastric ultrasound will be performed to confirm an empty stomach. During FMV, ultrasound images will be obtained at 30, 60, and 90 seconds. Gastric insufflation will be detected by the change in gastric cross-sectional area (ΔCSA).
DEVICE	"Ultrasound-Guided Optimization of Inspiratory Pressure During Facemask Ventilation"	Description: Group D will be subjected to an inspiratory pressure of 25 cmH₂O. A curvilinear ultrasound probe will be placed in the epigastric region to visualize the antrum. Baseline gastric ultrasound will be performed to confirm an empty stomach. During FMV, ultrasound images will be obtained at 30, 60, and 90 seconds. Gastric insufflation will be detected by the change in gastric cross-sectional area (ΔCSA).

Timeline

• Start date: 2026-04-01
• Primary completion: 2027-04-01
• Completion: 2027-04-15
• First posted: 2026-03-18
• Last updated: 2026-03-18

Locations

1 site across 1 country: Egypt