High Flow Nasal Cannula Oxygen During Sedation for Video-assisted Thoracoscopic Surgery

Study Overview
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Brief Summary
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High-flow nasal cannula (HFNC) is a device that delivers10 to 70 L min-1 of heated, humidified 100% oxygen via nasal route. It provides positive airway pressure, decreases dyspnea, decreases the work of breathing, and improves comfort

Detailed Description
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Beneficial effects of the HFNC system have been assessed based on 3 physiologic conditions: decreased dead space, a high concentration of inspiratory oxygen, and positive pressure in the oro-laryngeal cavity.Studies have shown that it improves oxygenation in various perioperative settings such as the apneic patients, patients with respiratory failure , and patients undergoing bronchoscopy

Official Title
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Preventing Deoxygenation With High Flow Nasal Cannula Oxygen During Sedation for Video-assisted Thoracoscopic Surgery: A Randomized Controlled Trial

Conditions
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Chronic Obstructive Pulmonary Disease, Respiratory Failure

Intervention / Treatment
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* Combination Product: High flow nasal cannula
* Combination Product: CONTROL


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA physical status II and III, undergoing VATS Exclusion Criteria: refusal of patients extrem of age

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: HFNC group<br>For HFNC group, F&P AIRVOTM 2 will be adjusted to give the patients the oxygen flow at 50L/min and the FiO2 at 1.0.Then after three minutes of preoxygenation, sedation will be conducted by giving 25 µg fentanyl and a bolus of 1 mg/kg propofol followed by continuous infusion of propofol using a target-controlled infusion system (TCI pump TE371; Terumo Corporation, TokyoJapan). | Combination Product: High flow nasal cannula<br>* using sedation with the HFNC F&P AIRVOTM 2 to maintain oxygenation<br>* Other names: HFNC;|
| Placebo Comparator: control group<br>induction of general anaesthesia will be done using 2 mg/kg propofol and 1 µg/kg fentanyl. Double lumen tube will be facilitated by cisatracurium 0.2 mg/kg. Anaesthesia will be maintained with isoflurane 0.8 %-1% in 100% oxygen and maintenance dose of cisatracurium 0.02 mg/kg when needed. At the end of surgery, residual neuromuscular paralysis will be antagonized with neostigmine 0.05 mg/kg and atropine 0.01 mg/kg. | Combination Product: CONTROL<br>* using general anaesthesia with one lung ventilation (OLV) technique<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| arterial partial pressures of oxygen | an arterial blood sample will be taken after induction of anaesthesia then every 10 min till the end of the operation. | two hours | 
| pH measurement | an arterial blood sample will be taken after induction of anaesthesia then every 10 min till the end of the operation. | two hours |