Airway Deadspace in Children: Air-Q Versus Endotracheal Tube

Study Overview
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Brief Summary
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The objective of this study will be to measure the airway deadspace associated with use of appropriately sized an AirQ, a commonly used supraglottic airway in young children weighing between 5 and 20 kg and compare that to the airway deadspace associated with use of an endotracheal tube (ETT) in similarly sized children undergoing controlled ventilation.

Detailed Description
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There is an increasing interest in the use of supraglottic airway devices in progressively younger and younger patients. One issue that has not been well evaluated is the contribution of these devices to airway dead space in young children and infants. Volumetric capnography is the only non-invasive technology available at the current time to evaluate airway deadspace. Volumetric capnography essentially monitors the flow of CO2 over time and from the expired waveform one can determine different respiratory parameters including dead space. This is clinically important in young children as the clinician begins to evaluate whether or not to use an endotracheal tube or supraglottic airway in these patients. To perform this investigation the study team will use volumetric capnography to examine the airway dead space associated with these devices during and elective general surgery and urologic procedures in healthy children between the ages of 0 and 6 years of age (roughly 5-20 kg). Participants in the study will be given ETT or Air-Q as an intervention, but the investigator does not assign specific interventions to the study participants.

Official Title
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A Prospective Comparison of the Airway Deadspace Associated With the Air-Q® and Endotracheal Tube Using Volumetric Capnography in Young Children

Conditions
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Airway Deadspace

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients between the ages of 3 months and 6 years of age weighing between 5 and 20 kg Patient presenting outpatient urologic or general surgery Exclusion Criteria: History of difficult airway/intubation Patients suspected to have a difficult airway. Morbid obesity BMI >39 Emergency status of surgery Patients exposed to second hand smoke Patients with Asthma Patients with a URI symptom such as nasal drainage, cough, or fever within 7 days of the date of surgery History of Prematurity

Ages Eligible for Study
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Minimum Age: 3 Months
Maximum Age: 6 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Air-Q 5-9kg<br>Participants weighing 5-9kg may be chosen to wear the Air-Q device. | |
| Air-Q 10-14kg<br>Participants weighing 10-14kg may be chosen to wear the Air-Q device. | |
| Air-Q 15-20kg<br>Participants weighing 15-20kg may be chosen to wear the Air-Q device. | |
| ETT 5-9kg<br>Participants weighing 5-9kg may be chosen to wear the ETT device. | |
| ETT 10-14kg<br>Participants weighing 10-14kg may be chosen to wear the ETT device. | |
| ETT 15-20kg<br>Participants weighing 15-20kg may be chosen to wear the ETT device. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Value of Airway Dead Space | A mean value observed over the first 10 minutes following placement of the ETT or the AirQ at the beginning of the case will be recorded. | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lung Compliance measured by Respironics NM3 respiratory monitors | The values of lung compliance will be collected and reported. | 10 minutes | 
| Airway Resistance measured by Respironics NM3 respiratory monitors | The value of resistance to flow in the airways will be collected and reported | 10 minutes | 
| Volume of Carbon Dioxide Associated with the Devices | The volume of carbon dioxide associated with the devices will be recorded and reported. | 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ventilation, pediatrics, airway management, respiration