AtelectLUS: Atelectasis After Inhalation or Intravenous Induction in Pediatric Anesthesia
Study Details
Study Description
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
Respiratory complications, among which atelectasis, are a common cause of adverse events in pediatric anesthesia. Lung ultrasound (LUS) examination is a point of care, non-invasive, radiation-free tool with high sensitivity and specificity for the identification of anesthesia-induced atelectasis in children.
Inhalation induction is commonly performed in pediatric anesthesia to avoid pain at venipuncture or to facilitate vein cannulation. This technique has been associated with a higher rate of respiratory adverse events but no study has investigated the role of inhalation or intravenous induction on lung atelectasis development in pediatric anesthesia.
The investigators will perform this study aiming to describe the impact of inhalation versus intravenous induction technique on atelectasis formation during anesthesia induction in children of different ages.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Inhalatory induction Patients who will be induced via mask with inhalators anesthetic gases |
Other: Type of anesthesia induction
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
|
| Intravenous induction Patients who will be induced with intravenous anesthetics |
Other: Type of anesthesia induction
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
|
Outcome Measures
Primary Outcome Measures
- Global LUS score [Upon completion of induction and subsequent controls at end of surgery and 1 postoperative day]
Sum of the LUS scores given to all the lung areas. Score points vary from 0 to 4, where 0 means normality of the lung and 4 refers to serious compromise of normal ultrasound normality.
- Signs of atelectasis [Upon completion of induction and and subsequent controls at end of surgery and 1 postoperative day]
Number of lung areas presenting a sub pleural consolidation
Eligibility Criteria
Criteria
Inclusion Criteria:
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scheduled for elective surgery under general anesthesia
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parental consent
Exclusion Criteria:
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American Society of Anesthesiologists (ASA) physical status III-VI
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neuromuscular disease
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chronic lung disease
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cardiopathy
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thoracic cage malformations
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chronic home ventilation (either invasive or non-invasive)
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positive history of foreign body inhalation
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required immediate life-saving procedures
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lack of parental consent
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Vittore Buzzi Children's Hospital | Milan | Italy | 20154 |
Sponsors and Collaborators
- Vittore Buzzi Children's Hospital
Investigators
- Study Director: Anna Camporesi, M.D., Vittore Buzzi Children's Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- 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.
- 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.
- 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.
- 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.
- 2022/ST/147