Importance of Integrated Pulmonary Index in Pediatric Bronchoscopy
Condition: Monitored Anesthesia Care; Respiratory Monitoring
Study type: Interventional

Summary: 
      Integrated Pulmonary Index (IPI) is a tool that provides numerical values on a scale of 1-10
      based on physiological parameters such as peripheral oxygen saturation (SpO2), pulse rate,
      respiratory rate, end-tidal carbon dioxide (ETCO2). It is a valuable monitor for sedation
      procedures and can provide early warning during cardiorespiratory derangements. In this
      study, we wanted to evaluate the value of IPI in cases of pediatric bronchoscopy performed
      under sedation. Our outcome measure will be the correlation of IPI values with standard
      monitoring parameters.
    

Detailed description: 
      Bronchoscopy is a procedure that is frequently applied in diagnostic or interventional
      conditions like hemoptysis, tracheobronchial stenosis, malignancy, recurrent lung infections,
      etc. It is routinely performed under general anesthesia or sedation in pediatric cases. In
      our clinic, we routinely perform diagnostic or interventional pediatric bronchoscopy
      procedures with an anesthesia team outside the operating room under monitored anesthetic care
      (MAC). Routine monitoring of MAC consists of electrocardiography (ECG), non-invasive blood
      pressure (NIBP), and peripheral oxygen saturation (SpO2). These monitorizations are described
      as minimum in many practice guidelines, and sometimes monitors such as end-tidal carbon
      dioxide (ETCO2), body temperature, analgesia/nociception index (ANI) can be added to them.

      Integrated Pulmonary Index (IPI) is a tool that provides numerical values on a scale of 1-10
      based on physiological parameters such as peripheral oxygen saturation (SpO2), pulse rate,
      respiratory rate, end-tidal carbon dioxide (ETCO2).(1,2) When these parameters exceed
      physiological limits, patients require interventions consisting of various maneuvers or drug
      administration in order to maintain the normal functioning of the cardiorespiratory system.
      If we look at the scoring, a score of 8-10 is considered normal, a score of 5-7 indicates a
      situation that may require intervention, and a score of 1-4 indicates that the patient needs
      intervention.

      The above-mentioned IPI is a relatively new tool, and there is limited data in the literature
      regarding its usability in patients undergoing interventional procedures under MAC.(3,4) In
      this study, we wanted to evaluate the safety of IPI in cases of pediatric bronchoscopy
      performed under sedation. Routine monitoring and drug applications for the procedure will be
      in accordance with the institutional protocols, and additional IPI monitoring will be
      performed. Our outcome measure will be the correlation of IPI values with standard monitoring
      parameters.
    

Intervention name(s): Integrated Pulmonary Index (IPI) monitoring; propofol; ketamine
Intervention type(s): Device; Drug; Drug
Intervention description(s): Integrated Pulmonary Index (IPI) monitor will be applied to the patients, to provide numerical data obtained from the measurements of end-tidal carbon dioxide, respiratory rate, oxygen saturation measured by pulse oximetry (SpO2), and pulse rate.; propofol; ketamine
Intervention MeSH terms: Ketamine; Propofol
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Diagnostic