Comparison of Two-hand Mask Ventilation Technique: Standard V-E Versus Reversal V-E Technique

Vanderbilt University Medical Center

Status: Completed

Conditions: Intubation

Treatments: Procedure: Standard V-E ventilation technique; Procedure: Reversal V-E ventilation technique

Study type: Interventional

Funder types: Other

Identifiers

NCT03170037

170299

Details and patient eligibility

About

This study hypothesizes that a novel reversal V-E ventilation technique will retain its high efficiency as that of standard V-E technique and will be easier to use.

Full description

Despite advances in intubation technology, difficult airways persist. Because it is failure to oxygenate, not failure to intubate, that ultimately leads to brain injury and cardiovascular collapse, effective mask ventilation is at least as important as successful intubation. Therefore optimizing mask ventilation is crucial for clinicians. When difficult mask ventilation encounters, clinicians often switch to two hand technique to hold the mask including either "C-E" clamp or "V-E" clamp. Both volume mode ventilation and pressure mode ventilation are superior with the V-E technique as compared to the C-E technique. The study will test the hypothesis that a novel reversal V-E mask ventilation technique will retain its high efficiency as that of standard V-E technique but be easier to use than standard V-E technique.

Enrollment: 92 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Over 18 years of age
• Requiring general anesthesia
• BMI =>30

Exclusion criteria

• Untreated ischemic heart diseases
• Respiratory disorders, including COPD and asthma
• American Society of Anesthesiologists(ASA) physical class of 4 or greater
• Undergoing emergency surgery
• Requiring rapid sequence intubation for aspiration protection
• Non propofol - induction of anesthesia
• Requiring fiberoptic intubation
• Pregnant women or women who have given birth within the last month

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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92 participants in 2 patient groups

Standard V-E ventilation technique

Active Comparator group

Description:

After induction of anesthesia subject will be ventilated using the standard V-E ventilation technique. Ventilation will be carried out using pressure mode ventilation at respiratory rate of 10 breaths per minute, I:E ratio of 1:2, peak inspiratory pressure of 20cmH2O and no PEEP. If the subjects can be adequately ventilated, as defined by perceivable chest movement and end tidal CO2 during the first three breaths, ventilation will continue for total ten breaths.

Treatment:

Procedure: Standard V-E ventilation technique

Reversal V-E ventilation technique

Experimental group

Description:

After induction of anesthesia subject will be ventilated using the reversal V-E ventilation technique. Ventilation will be carried out using pressure mode ventilation at respiratory rate of 10 breaths per minute, I:E ratio of 1:2, peak inspiratory pressure of 20cmH2O and no PEEP. If the subjects can be adequately ventilated, as defined by perceivable chest movement and end tidal CO2 during the first three breaths, ventilation will continue for total ten breaths.

Treatment:

Procedure: Reversal V-E ventilation technique