Is Effective Preoxygenation in Elderly Patients Related to Position?

Study Overview
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Brief Summary
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The purpose of this study is to investigate the effect of the head-up position of 20 and 30 degrees on the ETO2 reaching time of 85% and the desaturation time of 92% after intubation in elderly patients compared to the supine position.

Detailed Description
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Patients will be randomized into 3 groups. The patients will lay in the supine position, in the control group and 20 and 30 degrees head up position in other two groups. Each patient will be preoxygenated with well fitting anaesthesia face mask with FiO2 of 100% at least 6L of flow until the ETO2 reaches concentration of 85%. The angle (20 or 30 degrees) formed by the patients' bodies (hips and feet parallel to the ground, lifting the back from the ground plane) with the ground will be measured with a spirit level, angle meter, and confirmed with a smartphone application. The time to reach ETO2 85% by starting preoxygenation in patients will be measured and recorded with a stopwatch. When the target is reached, anesthesia induction will be performed and the patients will be intubated. After the start of the intubation attempt, the stopwatch will be started again, after intubation, the patient will be ventilated with a balloon once and the location of the tube will be confirmed, the circuit will be separated and SpO2 will be expected to go down to the level of 92 % and recorded during this time.

Official Title
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Is Effective Preoxygenation in Elderly Patients Related to Position?

Conditions
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Anesthesia Intubation Complication

Intervention / Treatment
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* Procedure: Head up positioning during preoxygenation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age above 65 years ASA 1-2 Exclusion Criteria: heart failure uncooperative patients refusing well fitting face mask before reaching EtO2 85% chronic lung disease anemia (hb<8gr/dl) BMI>40 neurological sequela

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 95 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: control<br>patients will be preoxygenated in supine position | Procedure: Head up positioning during preoxygenation<br>* patients will be preoxygenated in head up position<br>|
| Experimental: 20 degree<br>patients will be preoxygenated in 20 degrees head up position | Procedure: Head up positioning during preoxygenation<br>* patients will be preoxygenated in head up position<br>|
| Experimental: 30 degree<br>patients will be preoxygenated in 30 degrees head up position | Procedure: Head up positioning during preoxygenation<br>* patients will be preoxygenated in head up position<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time ETO2 85% | Time to reach ETO2 85 % | Time between placement of face mask and end tidal oxygen concentration reaches 85 % | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Desaturation time | Time to reach the Spo2 of 92 % after intubation | Time between initiation laryngoscopy for endotracheal intubation and peripheral oxygen saturation reaches 92 % measured by pulseoxymeter | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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preoxygenation, elderly