Improvement of Laryngoscopic View by Bed-up-head-elevated Position During Tracheal Intubation in Paediatric Patients

NCT05885789 | Unknown

• 1 other identifier: BUHE in paediatric
• Study Type: observational
• Target: 125
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this prospective observational study is to learn about improvement of laryngoscopic view by Bed-Up-Head-Elevated (BUHE) during tracheal intubation in paediatric patients. The main question it aims to answer is: 1\. Does BUHE position improve laryngoscopic view during paediatric intubation? Participants age 3-12 year-old going for elective surgery under general anaesthesia requiring tracheal intubation will undergo laryngoscopic twice, first in sniffing position (SP) and second during BUHE position. POGO score during each laryngoscope will be compared. Additionally, ease of handling of laryngoscope during each position will be assessed.

Conditions

Paediatric Airway Management

Keywords

Paediatric; Intubation; Laryngoscopy; Head position; BUHE

Outcome Measures

Primary Outcomes (1)

• Change in Percentage of Glottic Opening (POGO) score after BUHE position

  Compare change in Percentage of Glottic Opening (POGO) score in sniffing position (SP) and after BUHE position. The POGO score is expressed as a percentage of glottis exposure in the laryngoscopy view, which is expressed as 100% for a fully exposed glottis, from the anterior commissure of the vocal cords to the inter-arytenoid notch. POGO score of 0% corresponds to no visualisation of laryngeal structure.

  Immediate during procedure

Secondary Outcomes (1)

• Ease of handling of laryngoscope

  Immediate during procedure

Study Arms (1)

Paediatric patients

Procedure: Intubation in Bed-Up-Head-Elevated (BUHE) position

Interventions

Intubation in Bed-Up-Head-Elevated (BUHE) position PROCEDURE

Comparing laryngoscopic view in paediatric patients during sniffing position and BUHE position

Paediatric patients

Eligibility Criteria

• Age: 3 Years - 12 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)
• Sampling Method: Non-Probability Sample

Study Population

Paediatric patients age 3-12 year-old undergoing elective surgery under general anaesthesia requiring tracheal intubation

You may qualify if:

• Age 3 to 12 years
• Elective surgery under general anaesthesia requiring tracheal intubation

You may not qualify if:

• Parents' / Guardian's refusal
• Known case of difficult airway or airway malformation or airway obstruction
• Patients with respiratory or cardiovascular disease
• Patients requiring rapid sequence induction
• Recent Upper Respiratory Tract Infection (URTI) of 2 weeks

Sponsors & Collaborators

• University of Malaya: lead

Study Sites (1)

University of Malaya Medical Center

Kuala Lumpur, 59100, Malaysia

RECRUITING

Related Publications (9)

• Karsli C. Managing the challenging pediatric airway: Continuing Professional Development. Can J Anaesth. 2015 Sep;62(9):1000-16. doi: 10.1007/s12630-015-0423-y. Epub 2015 Aug 5.

  PMID: 26243378 BACKGROUND

• Schmidt AR, Weiss M, Engelhardt T. The paediatric airway: basic principles and current developments. Eur J Anaesthesiol. 2014 Jun;31(6):293-9. doi: 10.1097/EJA.0000000000000023.

  PMID: 24247412 BACKGROUND

• Holm-Knudsen RJ, Rasmussen LS. Paediatric airway management: basic aspects. Acta Anaesthesiol Scand. 2009 Jan;53(1):1-9. doi: 10.1111/j.1399-6576.2008.01794.x.

  PMID: 19128325 BACKGROUND

• Vialet R, Nau A. Effect of head posture on pediatric oropharyngeal structures: implications for airway management in infants and children. Curr Opin Anaesthesiol. 2009 Jun;22(3):396-9. doi: 10.1097/aco.0b013e3283294cc7.

  PMID: 19434789 BACKGROUND

• Kim EH, Ji SH, Song IK, Lee JH, Kim JT, Kim HS. Simple method for obtaining the optimal laryngoscopic view in children: A prospective observational study. Am J Emerg Med. 2017 Jun;35(6):867-870. doi: 10.1016/j.ajem.2017.01.048. Epub 2017 Jan 24.

  PMID: 28139308 BACKGROUND

• Ahn JH, Kim D, Gil NS, Son YH, Seong BG, Jeong JS. Improvement of laryngoscopic view by hand-assisted elevation and caudad traction of the shoulder during tracheal intubation in pediatric patients. Sci Rep. 2019 Feb 4;9(1):1174. doi: 10.1038/s41598-018-37770-6.

  PMID: 30718623 BACKGROUND

• Lee BJ, Kang JM, Kim DO. Laryngeal exposure during laryngoscopy is better in the 25 degrees back-up position than in the supine position. Br J Anaesth. 2007 Oct;99(4):581-6. doi: 10.1093/bja/aem095. Epub 2007 Jul 4.

  PMID: 17611252 BACKGROUND

• Black AE, Flynn PE, Smith HL, Thomas ML, Wilkinson KA; Association of Pediatric Anaesthetists of Great Britain and Ireland. Development of a guideline for the management of the unanticipated difficult airway in pediatric practice. Paediatr Anaesth. 2015 Apr;25(4):346-62. doi: 10.1111/pan.12615. Epub 2015 Feb 16.

  PMID: 25684039 BACKGROUND

• Tsan SEH, Lim SM, Abidin MFZ, Ganesh S, Wang CY. Comparison of Macintosh Laryngoscopy in Bed-up-Head-Elevated Position With GlideScope Laryngoscopy: A Randomized, Controlled, Noninferiority Trial. Anesth Analg. 2020 Jul;131(1):210-219. doi: 10.1213/ANE.0000000000004349.

  PMID: 31348051 RESULT

MeSH Terms

Interventions

Intubation; Patient Positioning

Intervention Hierarchy (Ancestors)

Therapeutics; Investigative Techniques; Patient Care; Health Services; Health Care Facilities Workforce and Services

Study Officials

• Bao Zhen Dr. Kim, MD

  University of Malaya Medical Center

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Bao Zhen Dr. Kim, MD

CONTACT

+6016-7978582; zhenkim1990@gmail.com

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: May 22, 2023
• First Posted: June 2, 2023
• Study Start: March 1, 2023
• Primary Completion: May 31, 2024
• Study Completion: May 31, 2024
• Last Updated: June 5, 2023

Record last verified: 2023-06

Locations

MY (1)