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Trial registered on ANZCTR
Registration number
ACTRN12617000337370
Ethics application status
Approved
Date submitted
28/02/2017
Date registered
3/03/2017
Date last updated
14/08/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Addition of nasal cannula can either impair or enhance preoxygenation with a bag valve mask: a randomised crossover trial comparing oxygen flow rates
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Scientific title
Comparison of end-tidal oxygen at 3-minutes using a combination nasal cannulae at different flow rates and a bag valve mask in healthy volunteers
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Secondary ID [1]
291295
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nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
intubation
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preoxygenation
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Condition category
Condition code
Anaesthesiology
301857
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The study design is five-period crossover study (repeated measures design). Participants will be required to complete five trials of 3-minutes pre-oxygenation with 100% oxygen in using a bag valve mask (BVM) (at 15l/min) and nasal cannula (NC) in all of the following conditions; BVM alone, BVM+NC at 0l/min, BVM+NC at 5l/min, BVM+NC at 10l/min, BVM+NC at 15l/min, At the end of each trial, oxygen will be measured by an expiratory breath into an oxygen analyser. There will be followed by a washout period of 2 minutes after which the ETO2 will be remeasured to ensure it is within 1% of the participants baseline.
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Intervention code [1]
297320
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Treatment: Drugs
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Intervention code [2]
297321
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Treatment: Devices
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Comparator / control treatment
The BVM-only condition is the comparator.
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Control group
Active
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Outcomes
Primary outcome [1]
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End-tidal oxygen, assessed with a paramagnetic oxygen analyser from a standard anaesthetic machine. The same analyser will be used for all trials.
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Assessment method [1]
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Timepoint [1]
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after 3-minutes of preoxygenation
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Secondary outcome [1]
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Comfort of breathing as measured by visual analog scale
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Assessment method [1]
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Timepoint [1]
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after 3-minutes of preoxygenation
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Eligibility
Key inclusion criteria
No regular cardiovascular or respiratory medication, no history of chronic respiratory disease.
Attendees at the Greater Sydney Area HEMS governance day,
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Minimum age
16
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Pregnancy, lung disease, known or suspected coronary or cerebrovascular disease, treatment for asthma or
COPD, previous exposure to bleomycin, participants with beards, dentures or facial abnormalities affecting mask
seal.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random sequence generation by statistical software package 'R'.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
The sequence by which the trials are to conducted will by a balanced Latin-Squares design. This allows the sequence of trials to be randomised, but balanced so that, if one participant was to conduct the trials in a particular order, another participant will perform their trials in the reverse of that order.
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Phase
Phase 2
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Type of endpoint/s
Pharmacodynamics
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/03/2016
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Date of last participant enrolment
Anticipated
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Actual
1/06/2016
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Date of last data collection
Anticipated
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Actual
1/06/2016
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Sample size
Target
40
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Accrual to date
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Final
39
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment postcode(s) [1]
15468
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2200 - Bankstown Aerodrome
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Ambulance NSW
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Address [1]
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Aero medical and retrieval services
Drover Rd
Bankstown
Nsw 2200
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Ambulance Service NSW
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Address
Aeromedical and retreival services
Drover Road
Bankstown Airport
NSW 2200
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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nil
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Address [1]
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nil
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Country [1]
294609
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Sydney Local Health District
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Ethics committee address [1]
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Research Ethics and Governance Office (REGO) Royal Prince Alfred Hospital Missenden Road CAMPERDOWN NSW 2050
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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09/12/2015
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Approval date [1]
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11/02/2016
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Ethics approval number [1]
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HREC/15/RPAH/587
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Summary
Brief summary
Objectives A critical safety component of emergency anaesthesia is the avoidance of hypoxaemia during the apnoeic phase of a rapid sequence intubation. Preoxygenation with a bag valve mask (BVM) or anaesthetic circuit may be improved with supplemental oxygen by nasal cannulae (NC) if there is a mask leak. In addition, NC are recommended for apnoeic oxygenation after induction and may be placed prior to preoxygenation . However, the optimum NC flow rate for preoxygenation or whether presence of NC itself creates a mask leak remains unclear. Methods We performed a randomized crossover study on healthy volunteers comparing BVM alone and BVM with NC flow rates of 0 (NC-0), 5 (NC-5), 10 (NC-10) and 15 (NC-15) litres per minute . Our primary outcome was end tidal oxygen (ETO2) after 3-minutes preoxygenation.
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Trial website
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Trial related presentations / publications
Mcquade D, Miller MR, Hayes-Bradley C. Addition of Nasal Cannula Can Either Impair or Enhance Preoxygenation With a Bag Valve Mask: A Randomized Crossover Design Study Comparing Oxygen Flow Rates. Anesthesia & Analgesia 2017; Publish Ahead of Print
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Public notes
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Contacts
Principal investigator
Name
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Dr David McQuade
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Address
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Department of Emergency Medicine
Wellington Hospital
Riddiford St, Newtown,
Wellington 6021
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Country
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New Zealand
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Phone
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+64 4385 5999
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Matthew Miller
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Address
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Department of Anaesthesia
Toronto Western Hospital,
399 Bathurst St,
Toronto,
ON M5T 2S8,
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Country
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Canada
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Phone
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+1 4162784580
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Matthew Miller
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Address
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Department of Anaesthesia
Toronto Western Hospital,
399 Bathurst St,
Toronto,
ON M5T 2S8,
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Country
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Canada
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Phone
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+1 4162784580
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Addition of nasal cannula can either impair or enhance preoxygenation with a bag valve mask: A randomized crossover design study comparing oxygen flow rates.
2018
https://dx.doi.org/10.1213/ANE.0000000000002341
N.B. These documents automatically identified may not have been verified by the study sponsor.
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