Oxygen Reserve Index and Prevention of Hyperoxemia

NCT05505032 | Completed Phase 4 FDA Drug FDA Device

• 1 other identifier: 2022-05/1838
• Study Type: interventional
• Target: 108
• Locations: 1 country
• Sites: 1

Brief Summary

In patients under general anesthesia, the oxygen level (FiO2) used in inspiration is usually adjusted by monitoring the peripheral oxygen saturation level (SpO2). As a non-invasive method, SpO2 monitoring is known as one of the required methods that can be used to adjust FiO2 and detect and treat hypoxemia. While SpO2 approaching 100% matches the value of 128 mmHg in arterial partial oxygen pressure (PaO2), in cases where PaO2 increases more, the investigators cannot follow this situation with SpO2 and cannot prevent hyperoxemia. As stated in the literature, hyperoxemia has positive effects in general anesthesia and intensive care, as well as negative effects such as increased inflammation, oxidative stress and ischemia-reperfusion. In addition, acute lung injury, development of atelectasis, increased mortality, and critical illness rates have been associated with hyperoxemia in many publications. The only way the investigators can use to measure the level of hyperoxemia seems to be arterial blood gas analysis, and this method limits the investigators use because it is invasive. The Oxygen Reserve Index (ORi™) (Masimo Corp., Irvine, CA, USA) is a variable related to real-time oxygenation reserve status in the mildly hyperoxemic range (approximately 100 - 200 mmHg PaO2). ORi can be defined as a multi-wavelength, noninvasive pulse co-oximetry sensor. ORi is a dimensionless index ranging from 0.00 (no reserve) to 1.00 (maximum reserve) depending on the oxygenation reserve status. There are very few studies in the literature using ORi to detect hyperoxemia. The investigators thought that if FiO2 levels used in preoxygenation, anesthesia maintenance and recovery stages in day surgeries were correlated with ORi levels, a threshold value could be determined for FiO2 levels during anesthesia stages in cases where invasive arterial blood gas could not be followed. This study aims to determine the relationship between SpO2, FiO2 and ORi during general anesthesia, to investigate the usefulness of ORi in determining the FiO2 threshold value during anesthesia stages as an indicator of hyperoxemia, and to investigate the effects of these values on the hemodynamics, recovery, agitation and nausea-vomiting states of the patients.

Conditions

Hyperoxemia; Oxygen Reserve Index; Hyperoxia; Fraction of Inspired Oxygen

Keywords

Oxygen Reserve Index; Hyperoxemia; Hyperoxia; Fraction of Inspired Oxygen

Outcome Measures

Primary Outcomes (1)

• FiO2 threshold value

  Correlation of FiO2 threshold value and ORi value

  Until the surgery is over

Study Arms (3)

Group F30

EXPERIMENTAL

In these patients, the FiO2 value will be adjusted to 30% in the perioperative period.

Drug: Oxygen; Device: Masimo Root Radical 7

Group F50

EXPERIMENTAL

In these patients, the FiO2 value will be adjusted to 50% in the perioperative period.

Drug: Oxygen; Device: Masimo Root Radical 7

Group F80

EXPERIMENTAL

In these patients, the FiO2 value will be adjusted to 80% in the perioperative period.

Drug: Oxygen; Device: Masimo Root Radical 7

Interventions

Oxygen DRUG

Determination of FiO2 threshold value as an indicator of hyperoxemia in anesthesia stages.

Group F30; Group F50; Group F80

Masimo Root Radical 7 DEVICE

We use it to measure the oxygen reserve index (ORi).

Group F30; Group F50; Group F80

Eligibility Criteria

• Age: 1 Year - 8 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Patients with an American Society of Anesthesiologists (ASA) score of 1

You may not qualify if:

• Patients with an American Society of Anesthesiologists (ASA) score of 2 and above

Sponsors & Collaborators

• Baskent University Ankara Hospital: lead

Study Sites (1)

Baskent University Ankara Hospital

Ankara, Cankaya, 06490, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Hyperoxia

Interventions

Oxygen

Condition Hierarchy (Ancestors)

Signs and Symptoms, Respiratory; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Chalcogens; Elements; Inorganic Chemicals; Gases

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Group F30 : FiO2 value is %30 Group F50 : FiO2 value is %50 Group F80 : FiO2 value is %80

Study Record Dates

• First Submitted: August 15, 2022
• First Posted: August 17, 2022
• Study Start: August 17, 2022
• Primary Completion: September 30, 2022
• Study Completion: October 30, 2022
• Last Updated: May 22, 2023

Record last verified: 2023-05

Locations

TU (1)