Goal Directed Numeric Coaching as a Means of Preoxygenation

Thomas Jefferson University

Status: Completed

Conditions: Pre-oxygenation

Treatments: Behavioral: Group A Standard 4 deep breaths measured in milliliters from the ventilator.; Behavioral: Group B Coached 4 deep breaths measured in milliliters from the ventilator

Study type: Interventional

Funder types: Other

Identifiers

NCT05978635

16D.091

Details and patient eligibility

About

Pre-oxygenation is an anesthetic technique that allows for extended apneic (suspension of breathing) time prior to attempted endotracheal intubation. A common method to achieve adequate pre-oxygenation is having a patient take four vital capacity breaths of 100% oxygen in thirty seconds. This study seeks to determine if goal directed numeric coaching can lead to more accurate vital capacities during this technique.

Enrollment: 86 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists Physical Status 1 and 2
• nonsmokers
• primary English speaking
• undergoing elective surgery with planned endotracheal intubation

Exclusion criteria

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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86 participants in 2 patient groups, including a placebo group

Group A

Placebo Comparator group

Description:

Anesthesia provider asks the patient to take 4 deep breaths by intermittently stating "take as deep a breath as you can". This is the standard of care technique for preoxygenation before induction of general anesthesia with the end point being 80% expired oxygen. The breath volumes in milliliters are recorded but not stated to the patient.

Treatment:

Behavioral: Group A Standard 4 deep breaths measured in milliliters from the ventilator.

Group B

Experimental group

Description:

Anesthesia provider asks the patient to take 4 deep breaths but provides coaching by informing the patient of the numeric volume (milliliters) to reach for every breath. Each tidal volume breath is measured using the anesthesia ventilator and the provider encourages the patient to achieve a higher tidal volume than previously achieved. For example, if the initial tidal volume achieved by the patient is 500 milliliter, the provider states, "that was a 500 milliliter breath, now try to achieve a 1000mL breath". The numeric goal should continue to increase above the patient's actual tidal volume. The breath volumes are recorded.

Treatment:

Behavioral: Group B Coached 4 deep breaths measured in milliliters from the ventilator