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Apneic OxygenationNCT02943629

A "Less-rapid" Sequence Anesthetic Induction/Intubation Sequence? Does Apneic Oxygenation by Means of an Oxygenating Laryngoscope Blade Prolong the "Duration of Apnea Without Desaturation" in Paralyzed Non-obese and Morbidly Obese Patients?

A study testing Apneic oxygenation: Eight minute, Without apneic oxygenation and Apneic oxygenation: five minutes in people with Apneic Oxygenation, run by Vanderbilt University.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The study will test the efficacy of the Pentax AWSTM video laryngoscope (VLS) equipped with a P Blade (Figure 1) as the means to provide Apneic Oxygenation (AO) and prolong Duration of Apnea Without Desaturation (DAWD) in non-obese and morbidly obese females. Read more about this study

Who is it for?
Ages 18 to 65 years, women only
Conditions the study is for
Apneic Oxygenation
What is being tested?
Apneic oxygenation: Eight minute, Without apneic oxygenation and Apneic oxygenation: five minutes
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
No sites listed yet
Study dates
Nov 2016to 1 Apr 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Female patients,
  • American Society of Anesthesiologists Rating 1-2,
  • Aged 18 through 65 years of age
  • Elective gynecological surgery via an abdominal approach (laparoscopic or open)
  • Already consented to general anesthesia necessitating endotracheal intubation.
  • Are candidates for anesthesia using laryngeal mask airway if needed

Who cannot join

  • Patient refusal to enter study
  • History of difficult mask ventilation
  • History of, or anticipated difficult intubation
  • Heavy Smokers (> 10 cigarettes per day)
  • Asthma
  • Chronic Obstructive Pulmonary Disease
Show all 12Show fewer
  • Heart Disease
  • Renal or Liver disease
  • Neurological disease.
  • Women scored at ≥ 3/4 on the modified Mallampati scale 30.
  • Women exhibiting other signs of a potential difficult intubation (limited neck flexion or extension; neck circumference > 30 cm; prominent incisors)
  • Patients with a baseline resting oxygenation level of less than 95%.

About this study

The study will test the efficacy of the Pentax AWSTM video laryngoscope (VLS) equipped with a P Blade (Figure 1) as the means to provide Apneic Oxygenation (AO) and prolong Duration of Apnea Without Desaturation (DAWD) in non-obese and morbidly obese females.

Read the detailed description

Pre-oxygenation/de-nitrogenation for three minutes of spontaneous breathing or alternatively four to eight deep breaths prior to rapid sequence anesthetic induction/intubation (RSII) in patients with healthy lungs, low oxygen demands and normal hemoglobin levels allows up to eight minutes of safe apnea time or DAWD.

The study will test the efficacy of the Pentax AWSTM video laryngoscope (VLS) equipped with a P Blade as the means to provide apneic oxygenation and prolong DAWD. The P Blade sports a suction conduit which can equally well provide a conduit for oxygen administration. The initial phase of the study will include non-obese healthy (ASAR 1-2) women patients requiring endotracheal anesthesia for gynecologic (open or laparoscopic) abdominal surgery. Subsequently a cohort of morbidly obese patients (BM I ≥ 40 kg/m2) also requiring gynecologic abdominal access will be recruited for investigation.

Participants of each group (obese, non-obese) will be randomized to apneic oxygenation with the the Pentax AWS Laryngoscope or no apneic oxygenation.

Being tested
Apneic oxygenation: Eight minute, Without apneic oxygenation, Apneic oxygenation: five minutes

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Apneic oxygenation: Eight minuteDevice

    A Pentax AWSTM video laryngoscope with attached P blade will be placed and then 10 l/minute flow of oxygen will be administered through the P blade (apneic oxygenation) for eight minutes, or less if SpO2 falls to ≤ 95%. The trachea will then be intubated and the ventilation of the lungs will commence using 100% oxygen until SpO2 ≥ 98%.

  • Without apneic oxygenationDevice

    A Pentax AWSTM video laryngoscope with attached P blade will be placed for eight minutes, or less if SpO2 falls to ≤ 95%. The trachea will then be intubated and the ventilation of the lungs will commence using 100% oxygen until SpO2 ≥ 98%.

  • Apneic oxygenation: five minutesDevice

    A Pentax AWSTM video laryngoscope with attached P blade will be placed and then 10 l/minute flow of oxygen will be administered through the P blade (apneic oxygenation) for five minutes, or less if SpO2 falls to ≤ 95%. The trachea will then be intubated and the ventilation of the lungs will commence using 100% oxygen until SpO2 ≥ 98%.

Study groups in NCT02943629
Study groupRoleWhat they receive
Non-Obese: Apneic Oxygenation: eight minuteExperimentalNon-obese healthy female patients requiring endotracheal anesthesia for gynecologic (open or laparoscopic) abdominal surgery will have the Pentax AWSTM video laryngoscope with attached P blade placed and then receive 10 l/minute flow of oxygen through the P blade (apneic oxygenation) for eight minutes, or earlier if SpO2 falls to ≤ 95%. The trachea will then be intubated and the ventilation of the lungs will commence using 100% oxygen until SpO2 ≥ 98%.
Receives: Device: Apneic oxygenation: Eight minute
Non-Obese: Without Apneic OxygenationOtherNon-obese healthy female patients requiring endotracheal anesthesia for gynecologic (open or laparoscopic) abdominal surgery will have the Pentax AWSTM video laryngoscope with attached P blade placed for eight minutes, or earlier if SpO2 falls to ≤ 95%. The trachea will then be intubated and the ventilation of the lungs will commence using 100% oxygen until SpO2 ≥ 98%.
Receives: Device: Without apneic oxygenation
Obese: Apneic Oxygenation: five minuteExperimentalMorbidly obese patients (BM I ≥ 40 kg/m2) requiring endotracheal anesthesia for gynecologic (open or laparoscopic) abdominal surgery will have the Pentax AWSTM video laryngoscope with attached P blade placed and then receive 10 l/minute flow of oxygen through the P blade (apneic oxygenation) for five minutes, or earlier if SpO2 falls to ≤ 95%. The trachea will then be intubated and the ventilation of the lungs will commence using 100% oxygen until SpO2 ≥ 98%.
Receives: Device: Apneic oxygenation: five minutes
Obese: Without Apneic OxygenationOtherMorbidly obese patients (BM I ≥ 40 kg/m2) requiring endotracheal anesthesia for gynecologic (open or laparoscopic) abdominal surgery will have the Pentax AWSTM video laryngoscope with attached P blade placed for five minutes, or earlier if SpO2 falls to ≤ 95%. The trachea will then be intubated and the ventilation of the lungs will commence using 100% oxygen until SpO2 ≥ 98%.
Receives: Device: Without apneic oxygenation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Duration of apnea without desaturation

    Measured: Time in seconds from the initiation of laryngoscopy until the time at which Sp02 falls to 95%, or until 8 minutes have elapsed

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Oct 2016 (estimated)
  2. Study startNov 2016
  3. Primary completion1 Apr 2019
  4. Study completion1 Apr 2019

Why it stopped: Lack of feasibility

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02943629
Sponsor's protocol ID
160579
Status last verified
May 2019
First submitted
20 Oct 2016
Last updated
8 May 2019
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • FRUMIN MJ, EPSTEIN RM, COHEN G. Apneic oxygenation in man. Anesthesiology. 1959 Nov-Dec;20:789-98. doi: 10.1097/00000542-195911000-00007. No abstract available.

    PubMed 13825447
  • Paolini JB, Donati F, Drolet P. Review article: video-laryngoscopy: another tool for difficult intubation or a new paradigm in airway management? Can J Anaesth. 2013 Feb;60(2):184-91. doi: 10.1007/s12630-012-9859-5. Epub 2012 Dec 12.

    PubMed 23233395
  • Tanoubi I, Drolet P, Donati F. Optimizing preoxygenation in adults. Can J Anaesth. 2009 Jun;56(6):449-66. doi: 10.1007/s12630-009-9084-z. Epub 2009 Apr 28.

    PubMed 19399574
  • Jense HG, Dubin SA, Silverstein PI, O'Leary-Escolas U. Effect of obesity on safe duration of apnea in anesthetized humans. Anesth Analg. 1991 Jan;72(1):89-93. doi: 10.1213/00000539-199101000-00016.

    PubMed 1984382
  • Shah U, Wong J, Wong DT, Chung F. Preoxygenation and intraoperative ventilation strategies in obese patients: a comprehensive review. Curr Opin Anaesthesiol. 2016 Feb;29(1):109-18. doi: 10.1097/ACO.0000000000000267.

    PubMed 26545146
  • Weingart SD, Levitan RM. Preoxygenation and prevention of desaturation during emergency airway management. Ann Emerg Med. 2012 Mar;59(3):165-75.e1. doi: 10.1016/j.annemergmed.2011.10.002. Epub 2011 Nov 3.

    PubMed 22050948
  • De Jong A, Molinari N, Pouzeratte Y, Verzilli D, Chanques G, Jung B, Futier E, Perrigault PF, Colson P, Capdevila X, Jaber S. Difficult intubation in obese patients: incidence, risk factors, and complications in the operating theatre and in intensive care units. Br J Anaesth. 2015 Feb;114(2):297-306. doi: 10.1093/bja/aeu373. Epub 2014 Nov 27.

    PubMed 25431308
  • Gebremedhn EG, Mesele D, Aemero D, Alemu E. The incidence of oxygen desaturation during rapid sequence induction and intubation. World J Emerg Med. 2014;5(4):279-85. doi: 10.5847/wjem.j.issn.1920-8642.2014.04.007.

    PubMed 25548602
  • Altermatt FR, Munoz HR, Delfino AE, Cortinez LI. Pre-oxygenation in the obese patient: effects of position on tolerance to apnoea. Br J Anaesth. 2005 Nov;95(5):706-9. doi: 10.1093/bja/aei231. Epub 2005 Sep 2.

    PubMed 16143575
  • Archer GW Jr, Marx GF. Arterial oxygen tension during apnoea in parturient women. Br J Anaesth. 1974 May;46(5):358-60. doi: 10.1093/bja/46.5.358. No abstract available.

    PubMed 4157184
  • McClelland SH, Bogod DG, Hardman JG. Apnoea in pregnancy: an investigation using physiological modelling. Anaesthesia. 2008 Mar;63(3):264-9. doi: 10.1111/j.1365-2044.2007.05347.x.

    PubMed 18289232
  • McClelland SH, Bogod DG, Hardman JG. Pre-oxygenation and apnoea in pregnancy: changes during labour and with obstetric morbidity in a computational simulation. Anaesthesia. 2009 Apr;64(4):371-7. doi: 10.1111/j.1365-2044.2008.05785.x.

    PubMed 19317700
  • Patil S, Sinha P, Krishnan S. Successful delivery in a morbidly obese patient after failed intubation and regional technique. Br J Anaesth. 2007 Dec;99(6):919-20. doi: 10.1093/bja/aem326. No abstract available.

    PubMed 18006534
  • Hawkins JL, Chang J, Palmer SK, Gibbs CP, Callaghan WM. Anesthesia-related maternal mortality in the United States: 1979-2002. Obstet Gynecol. 2011 Jan;117(1):69-74. doi: 10.1097/AOG.0b013e31820093a9.

    PubMed 21173646
  • Teller LE, Alexander CM, Frumin MJ, Gross JB. Pharyngeal insufflation of oxygen prevents arterial desaturation during apnea. Anesthesiology. 1988 Dec;69(6):980-2. doi: 10.1097/00000542-198812000-00035. No abstract available.

    PubMed 3195773

Questions about this trial

What is this clinical trial studying?

A study testing Apneic oxygenation: Eight minute, Without apneic oxygenation and Apneic oxygenation: five minutes in people with Apneic Oxygenation, run by Vanderbilt University.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 8 May 2019. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Duration of apnea without desaturation (time frame: Time in seconds from the initiation of laryngoscopy until the time at which Sp02 falls to 95%, or until 8 minutes have elapsed). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02943629, which also lists 28 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 May 2019; AzTrials last refreshed its copy on 28 Oct 2026.

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