Clinical trial NCT05279170: MAsk VEntilation With Paratracheal Pressure In Children. Para Tracheal Compression to Prevent Gastric Insufflation in Children
Official title: Para Tracheal Compression to Prevent Gastric Insufflation During Positive Pressure Ventilation With Facemask in Children Under General Anaesthesia: an Efficiency Study
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Surgery
Anesthesia Intubation Complication
Keywords: Low Left Paratracheal esophagus Pressure
gastric insufflation
Echography
children
elective surgery
positive pressure ventilation
Lead sponsor: University Hospital, Lille
Sponsor class: OTHER
First posted: 2022-03-15
Enrollment: 72
Sex: ALL
Minimum age (years): 2
Maximum age (years): 10
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: PREVENTION

Brief summary: The use of cricoid pressure to prevent gastric aspiration or regurgitation in case of "full stomach" situation or emergency is still controversial in the adult population. Moreover this maneuver is no more recommended in children by some European pediatric anesthesia societies, because of a lack of evidence of its protective effect against gastric aspiration and its possible adverse effects.

A new approach to occlude effectively the esophageal lumen has been recently described in adults and has shown its effectiveness to prevent gastric insufflation. But this maneuver has so far not been evaluated in the pediatric population and could be an alternative to prevent gastro-esophageal regurgitation and pulmonary aspiration in children


Eligibility criteria: Inclusion Criteria:

* Children from 2 to 10 years of age who benefit from general anesthesia with or without intubation
* inhalation induction
* elective surgery
* ASA status 1 or 2
* consent of the child if he/she is able to express it
* consent of both parents and/or legal guardians
* socially insured

Exclusion Criteria:

* Child under 2 years old or \> 10 years
* body weight is over 40 kgs
* ASA status 3 or higher
* Emergency surgery or unscheduled surgery
* scheduled ENT or esogastric surgery
* Achalasia of the esophagus or history of GERD pathology
* History of esophageal surgery (NISSEN type)
* BMI indexed to age and sex showing childhood obesity
* Predictable mask ventilation difficulties
* History of Tracheostomy
* Child not insured by social security

Primary outcomes:
measure: Presence of air artefacts during positive pressure ventilation as evaluated by simultaneous gastric ultrasonography
timeFrame: We will perfom a unique measurement of gastric air artefact by ultrasonography after 2 minutes of positive pressure ventilation.
Secondary outcomes:
measure: The verification of the actual position of the esophagus on the left side of the trachea at the place where LPPP will be applied (feasibility of LLPP)
timeFrame: Before the beginning of positive pressure ventilation during 1 minute
measure: The safety of the LLPP maneuver: absence of any significant compression of the adjacent vessels as measured by US.
timeFrame: Before the beginning of positive pressure ventilation and during 1 minute
measure: The expired tidal volume and peak inspiratory pressure as measured during PPV to evaluate any difficulty in mask ventilation induced by LLPP.
timeFrame: At the beginning of positive pressure ventilation and during two minutes
Other outcomes:
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