Nasal High Flow in Bariatric Surgery

Study Overview
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Brief Summary
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High frequency nasal cannula (HFNC) provides an inspiration O2 fraction of 21-1% and it has a minimal dead space and can be well tolerated due to humidified air. Group I patients will be applied HFNC before and after bariatric surgery, Group II patients will be applied a constant O2 concentration via face mask. Oxygen pressure, oxygen saturation, carbon dioxide, respiration frequency, forced vital capacity will be measured before and after surgery.

Detailed Description
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Morbid obese patients are prone to atelectasis and hypoxemia after bariatric surgery. High frequency nasal cannula (HFNC) provides an inspiration O2 fraction of 21-1% and it has a minimal dead space and can be well tolerated due to humidified air. It provides 5-7 cm H2O positive end expiratory pressure to the airways and may prevent atelectasis. In the preoperative room, forced vital capacity, peripheral oxygen saturation (SpO2), respiratory frequency, heart rate (HR), blood pressure (BP), carbon dioxide, oxygen pressure and carbon dioxide partial pressure values in blood gas analysis will be recorded. We will apply HFNC in the preoperative and postoperative period to Group I patients, while applying a constant O2 concentration to Group II patients. After appliying HFNC for two hours in Group I patients and O2 via face mask in Group II patients measurements will be repeated. During surgery, similar mechanical ventilation parameters will be applied to the patients. After the operation Group I patients will be applied HFNC, while Group II patients will be applied O2 via face mask in the recovery room for two hours. Measurements will be repeated. Primary end point of the study is the association between oxygen pressure, carbon dioxide partial pressure values among preoperative before and after HFNC and O2 and postoperative times.

Official Title
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Effect of Nasal High Flow on Perioperative Oxygenation in Patients Undergoing Bariatric Surgery

Conditions
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Morbid Obesity

Intervention / Treatment
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* Other: Oxygen therapy via HFNC
* Other: Oxygen therapy via face mask


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with a body mass index of 40-55 kg/m2 American Society of Anesthesiologists score II-III Patients undergoing laparoscopic sleeve gastrectomy or one anastomosis gastric bypass Exclusion Criteria: Obstructive sleep apnea syndrome Using a non invasive mechanical ventilation device preoperatively Patients whoo will predicted to postanesthesia care unit admission postoperatively

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Oxygen therapy via HFNC<br>Patients who will be applied high frequency nasal cannula before and after surgery | Other: Oxygen therapy via HFNC<br>* Oxygen treatment will be applied to the patients via HFNC before and after surgery<br>|
| Active Comparator: Oxygen therapy via face mask<br>Patients who will be applied O2 via face mask before and after surgery | Other: Oxygen therapy via face mask<br>* Oxygen treatment will be applied to the patients via face mask before and after surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PO2 value | PO2 value will be measured before HFNC or face mask, after HFNC or face mask and after surgery | 24 hours | 
| PCO2 value | PO2 value will be measured before HFNC or face mask, after HFNC or face mask and after surgery | 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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morbid obesity, bariatric surgery, high frequency nasal cannula, oxygenation