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A Study of the Effect of Arterial Carbon Dioxide Tension on the Recovery of Spontaneous Respiration (RIP03)

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ClinicalTrials.gov Identifier: NCT01733446
Recruitment Status : Completed
First Posted : November 27, 2012
Last Update Posted : April 23, 2018
Sponsor:
Information provided by (Responsible Party):
University of Pennsylvania

Brief Summary:

The investigators data reveal an important new observation regarding the recovery of breathing during emergence from general anesthesia: respiration resumes as a prolonged abdominal expiration event.

The present study aims to further clarify the physiology of recovery of breathing with the addition of a cutaneous monitor for arterial carbon dioxide measurement and a comparison of two different recovery paradigms.


Condition or disease Intervention/treatment Phase
Surgery Anesthesia Other: Continuation of High Frequency Jet Ventilation (HFJV) Not Applicable

Detailed Description:

The present study will use non-invasive respiratory inductance plethysmography(RIP) and transcutaneous carbon dioxide measurement to compare recovery of respiration under constant Transcutaneous carbon dioxide measurement( ptcCO2) with continuous high frequency jet ventilation HFJV (study method) with recovery of respiration during rising and apnea (current standard).

The investigators hypothesize that the prolonged abdominal expiration that we observed during recovery of breathing in prior studies will be unaffected by arterial carbon dioxide (CO2) levels.


Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: A Study of the Effect of Arterial Carbon Dioxide Tension on the Recovery of Spontaneous Respiration With Respiratory Inductance Plethysmography (RIP) During High Frequency Jet Ventilation (HFJV) Under General Anesthesia
Study Start Date : September 2012
Actual Primary Completion Date : February 2018
Actual Study Completion Date : February 2018

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anesthesia

Arm Intervention/treatment
No Intervention: Standard anesthesia regimen
Positive pressure ventilation will be stopped at the same time infusions of anesthetic agents and spontaneous ventilation employed until emergence from anesthesia is observed. (This is standard protocol for everyday anesthesia management of this population.)
Experimental: Continuation of High Frequency Jet Ventilation ( HFJV)
In Group B after cessation of anesthetic infusions, High Frequency Jet Ventilation (HFJV) will continue through the endotracheal tube. Patient will be extubated when awake. Respiratory Inductance Plethysmography (RIP) and transcutaneous carbon dioxide (PtcCO2) measurements will continue for the duration of emergence.
Other: Continuation of High Frequency Jet Ventilation (HFJV)
In Group B, after cessation of anesthetic infusions, High Frequency Jet Ventilation (HFJV) will continue through the endotracheal tube. Patient will be extubated when awake. Respiratory Inductance Plethysmography (RIP) and Transcutaneous carbon dioxide (PtcCO2) measurements will continue for the duration of emergence.




Primary Outcome Measures :
  1. spontaneous breathing [ Time Frame: Day 0 in the operating room occurring in the specific time frame of the end of anesthesia to patient 's first breath ]
    The primary variable will be first breath as detected by Respiratory Inductance Plethysmography (RIP. This will occur in the operating room at the end of the surgery and anesthesia.)



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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Male or Female patients ages > 18 to < 80
  2. Scheduled for procedures under general anesthesia with jet ventilation
  3. Sign informed consent
  4. Candidate for total intravenous anesthesia with propofol and remifentanil (which is standard protocol in this type of population)

Exclusion Criteria:

  1. Absence of informed consent
  2. No planned use intra-operative use of jet ventilation
  3. Known difficulties with jet ventilation during prior surgical procedures
  4. Emergency surgery
  5. Baseline (oxygen saturation)SpO2 <92% on room air
  6. BMI > 50
  7. Pregnant or lactating females
  8. Skin damage, rash or significant lesions in the areas covered by the RIP bands or transcutaneous CO2 sensor.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01733446


Locations
United States, Pennsylvania
University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
Sponsors and Collaborators
University of Pennsylvania
Investigators
Principal Investigator: Joshua H Atkins, MD PhD University of Pennsylvania

Responsible Party: University of Pennsylvania
ClinicalTrials.gov Identifier: NCT01733446     History of Changes
Other Study ID Numbers: 816280
First Posted: November 27, 2012    Key Record Dates
Last Update Posted: April 23, 2018
Last Verified: April 2018

Keywords provided by University of Pennsylvania:
High frequency jet ventilation

Additional relevant MeSH terms:
Anesthetics
Central Nervous System Depressants
Physiological Effects of Drugs