Atelectasis After Inhalation or Intravenous Induction in Pediatric Anesthesia

NCT06069414 | Completed

• 1 other identifier: 2022/ST/147
• Study Type: observational
• Target: 326
• Locations: 1 country
• Sites: 1

Brief Summary

Children have a highly compliant chest wall and atelectasis formation occurs often during pediatric anesthesia. Inhalation induction is commonly performed in pediatric anesthesia but it is still unclear if this can have an effect on the development of atelectasis. Aim of this study is to investigate the impact of inhalation versus intravenous induction on atelectasis formation during anesthesia induction in children. Atelectasis will be evaluated with lung ultrasound before induction and right after induction.

Conditions

Atelectasis; Pediatric Anesthesia

Outcome Measures

Primary Outcomes (2)

• Global LUS score

  Sum of the LUS scores given to all the lung areas. Score points vary from 0 to 3, where 0 means normality of the lung and 3 refers to complete loss of aeration-tissue-like pattern or consolidation.

  Upon completion of induction and subsequent controls at end of surgery and 1 postoperative day

• Signs of atelectasis

  Number of lung areas presenting a sub pleural consolidation

  Upon completion of induction and and subsequent controls at end of surgery and 1 postoperative day

Study Arms (2)

Inhalatory induction

Patients who will be induced via mask with inhalators anesthetic gases

Other: Type of anesthesia induction

Intravenous induction

Patients who will be induced with intravenous anesthetics

Other: Type of anesthesia induction

Interventions

Type of anesthesia induction OTHER

Patients will receive inhalatory or intravenous anesthesia at their choice; both groups will be evaluated with lung ultrasound after induction to detect ultrasonografic signs of atelectasis

Inhalatory induction; Intravenous induction

Eligibility Criteria

• Age: 0 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Children under 18 years of age scheduled for general anesthesia due to surgery.

You may qualify if:

• scheduled for elective surgery under general anesthesia
• parental consent

You may not qualify if:

• American Society of Anesthesiologists (ASA) physical status III-VI
• neuromuscular disease
• chronic lung disease
• cardiopathy
• thoracic cage malformations
• chronic home ventilation (either invasive or non-invasive)
• positive history of foreign body inhalation
• required immediate life-saving procedures
• lack of parental consent

Sponsors & Collaborators

• Vittore Buzzi Children's Hospital: lead

Study Sites (1)

Vittore Buzzi Children's Hospital

Milan, 20154, Italy

Location

Related Publications (6)

• Sargent MA, McEachern AM, Jamieson DH, Kahwaji R. Atelectasis on pediatric chest CT: comparison of sedation techniques. Pediatr Radiol. 1999 Jul;29(7):509-13. doi: 10.1007/s002470050632.

  PMID: 10398785 BACKGROUND

• Acosta CM, Maidana GA, Jacovitti D, Belaunzaran A, Cereceda S, Rae E, Molina A, Gonorazky S, Bohm SH, Tusman G. Accuracy of transthoracic lung ultrasound for diagnosing anesthesia-induced atelectasis in children. Anesthesiology. 2014 Jun;120(6):1370-9. doi: 10.1097/ALN.0000000000000231.

  PMID: 24662376 BACKGROUND

• Zeng C, Lagier D, Lee JW, Vidal Melo MF. Perioperative Pulmonary Atelectasis: Part I. Biology and Mechanisms. Anesthesiology. 2022 Jan 1;136(1):181-205. doi: 10.1097/ALN.0000000000003943.

  PMID: 34499087 BACKGROUND

• Adler AC, Siddiqui A, Chandrakantan A, Matava CT. Lung and airway ultrasound in pediatric anesthesia. Paediatr Anaesth. 2022 Feb;32(2):202-208. doi: 10.1111/pan.14337. Epub 2021 Dec 1.

  PMID: 34797019 BACKGROUND

• de Graaff JC, Bijker JB, Kappen TH, van Wolfswinkel L, Zuithoff NP, Kalkman CJ. Incidence of intraoperative hypoxemia in children in relation to age. Anesth Analg. 2013 Jul;117(1):169-75. doi: 10.1213/ANE.0b013e31829332b5. Epub 2013 May 17.

  PMID: 23687233 RESULT

• Camporesi A, Roveri G, Vetrugno L, Buonsenso D, De Giorgis V, Costanzo S, Pierucci UM, Pelizzo G. Lung ultrasound assessment of atelectasis following different anesthesia induction techniques in pediatric patients: a propensity score-matched, observational study. J Anesth Analg Crit Care. 2024 Oct 5;4(1):69. doi: 10.1186/s44158-024-00206-x.

  PMID: 39369249 DERIVED

MeSH Terms

Conditions

Pulmonary Atelectasis

Condition Hierarchy (Ancestors)

Lung Diseases; Respiratory Tract Diseases

Study Officials

• Anna Camporesi, M.D.

  Vittore Buzzi Children's Hospital

  STUDY DIRECTOR

Study Design

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

Study Record Dates

• First Submitted: September 13, 2023
• First Posted: October 5, 2023
• Study Start: April 1, 2023
• Primary Completion: October 1, 2023
• Study Completion: November 1, 2023
• Last Updated: April 17, 2024

Record last verified: 2024-04

Data Sharing

• IPD Sharing: Will not share

Locations

IT (1)