Nose-close and Abdomen-compression in Pediatric Flexible Bronchoscopy (NPO-NC-AC)

Cho-yu Chan, MD

Status: Completed

Conditions: Bradycardia; Hypoxemia

Treatments: Other: NPO with Nose-close and Abdomen-compression

Study type: Interventional

Funder types: Other

Identifiers

NCT01629186

NPO-NC-AC in Ped. FB (Other Grant/Funding Number)

VGH-94-269C

Details and patient eligibility

About

The nasopharyngeal oxygen (NPO) with Nose-close (NC) and Abdomen-compression (AC) technique may use for support or rescue asphyxiated infants during Flexible bronchoscopy.

Full description

OBJECTIVES: To evaluate the efficacy of a novel cardiopulmonary resuscitation (CPR) technique-nasopharyngeal oxygenation with nose-close and abdomen-compression (NPO-NC-AC)-in small infants during flexible bronchoscopy (FB).

METHODS: Infants with body weight (BW) <5.0 kg and receiving nasal diagnostic or interventional FB (dFB, iFB) were enrolled. Under NPO (0.5 L/kg/min), when infant's heart rate (HR) <80 beats/min or oxygen saturation (SpO2) <85% for more than 10 seconds, rescue NC-AC was initiated. It was performed by (1) increased NPO flow to 0.5-1.0 L/kg/min; (2) NC 1 second for inspiration; and (3) AC 1 second for expiration with simultaneously released nostrils. Repeat doing steps (2) and (3) at a rate of 30 cycles/min until HR, SpO2, and blood pressure (BP) returned to normal. Cardiopulmonary parameters were monitored and analyzed.

Enrollment: 156 patients

Sex: All

Ages: Under 20 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• body weight (BW) less than 5.0 kg;
• receiving nasal approach flexible bronchoscopy.

Exclusion criteria

• cannot nasal approach flexible bronchoscopy.

Trial design

Primary purpose: Supportive Care

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

156 participants in 1 patient group

outcome

Experimental group

Description:

Cardiopulmonary parameters were measured and recorded at baseline, just before and at every minute during NC-AC, and at the end of the FB session. In infants who already had an arterial line, arterial blood gas (ABG) analyses were taken for study. Data was represented as mean ± SD. The results obtained from the baseline and different stages. The values were considered statistically significant only when p \< 0.05. Technique failure was defined as: any vital signs of hypoxia did not return to accepted levels(HR\>100 beat/min, SpO2\>90%, mean BP\>50 mmHg)within 2 minutes of the experimental CPR technique. Then traditional CPR procedures involving bag-mask ventilation, endotracheal intubation, Ambu bag ventilation or even chest compressions were substituted.

Treatment:

Other: NPO with Nose-close and Abdomen-compression