Effect of positive end expiratory pressure on non-hypoxic apnea time and atelectasis during induction of anesthesia in infant: A randomized controlled trial
This study aimed to assess the impact of positive-end-expiratory pressure (PEEP) on the non-hypoxic apnea time in infants during anesthesia induction with an inspired oxygen fraction of 0.8. This age stratified randomized controlled trial included patients under 1 year of age. Preoxygenation was per...
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| Veröffentlicht in: | Pediatric anesthesia 2024-11, Vol.34 (11), p.1146-1153 |
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| container_title | Pediatric anesthesia |
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| creator | Kim, Eun-Hee Park, Jung-Bin Kang, Pyoyoon Ji, Sang-Hwan Jang, Young-Eun Lee, Ji-Hyun Kim, Jin-Tae Kim, Hee-Soo |
| description | This study aimed to assess the impact of positive-end-expiratory pressure (PEEP) on the non-hypoxic apnea time in infants during anesthesia induction with an inspired oxygen fraction of 0.8.
This age stratified randomized controlled trial included patients under 1 year of age. Preoxygenation was performed using an inspired oxygen fraction of 0.8 for 2 min. Inspired oxygen fraction of 0.8 was administered via a face mask with volume-controlled ventilation at a tidal volume of 6 mL.kg
, with or without 7 cmH
O of PEEP. Tracheal intubation was performed after 3 min of ventilation; however, it was disconnected from the breathing circuit. Ventilation was resumed once the pulse oximetry readings reached 95%. The primary outcome was the non-hypoxic apnea time, defined as the time from the cessation of ventilation to achieving a pulse oximeter reading of 95%. The secondary outcome measures included the degree of atelectasis assessed by ultrasonography and the presence of gastric air insufflation.
Eighty-four patients were included in the final analysis. In the positive end-expiratory pressure group, the atelectasis score decreased (17.0 vs. 31.5, p |
| doi_str_mv | 10.1111/pan.14965 |
| format | Article |
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This age stratified randomized controlled trial included patients under 1 year of age. Preoxygenation was performed using an inspired oxygen fraction of 0.8 for 2 min. Inspired oxygen fraction of 0.8 was administered via a face mask with volume-controlled ventilation at a tidal volume of 6 mL.kg
, with or without 7 cmH
O of PEEP. Tracheal intubation was performed after 3 min of ventilation; however, it was disconnected from the breathing circuit. Ventilation was resumed once the pulse oximetry readings reached 95%. The primary outcome was the non-hypoxic apnea time, defined as the time from the cessation of ventilation to achieving a pulse oximeter reading of 95%. The secondary outcome measures included the degree of atelectasis assessed by ultrasonography and the presence of gastric air insufflation.
Eighty-four patients were included in the final analysis. In the positive end-expiratory pressure group, the atelectasis score decreased (17.0 vs. 31.5, p < .001; mean difference and 95% CI of 11.6, 7.5-15.6), while the non-hypoxic apnea time increased (80.1 s vs. 70.6 s, p = .005; mean difference and 95% CI of -9.4, -16.0 to -2.9), compared to the zero end-expiratory pressure group, among infants who are 6 months old or younger, not in those aged older than 6 months.
The application of positive end-expiratory pressure reduced the incidence of atelectasis and extended the non-hypoxic apnea time in infants who are 6 months old or younger. However, it did not affect the incidence of atelectasis nor the non-hypoxic apnea time in patients aged older than 6 months.</description><identifier>ISSN: 1155-5645</identifier><identifier>ISSN: 1460-9592</identifier><identifier>EISSN: 1460-9592</identifier><identifier>DOI: 10.1111/pan.14965</identifier><identifier>PMID: 38980197</identifier><language>eng</language><publisher>France: Wiley Subscription Services, Inc</publisher><subject>Anesthesia - methods ; Apnea ; Clinical trials ; Female ; Humans ; Hypoxia ; Infant ; Infant, Newborn ; Male ; Oximetry - methods ; Positive-Pressure Respiration - methods ; Pulmonary Atelectasis - etiology ; Pulmonary Atelectasis - prevention & control ; Ventilation</subject><ispartof>Pediatric anesthesia, 2024-11, Vol.34 (11), p.1146-1153</ispartof><rights>2024 The Author(s). Pediatric Anesthesia published by John Wiley & Sons Ltd.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c238t-cf27cd98220d92fc8b201c01013414d2e6a7d733ea471927763e677f72c33fab3</cites><orcidid>0000-0002-2661-7944 ; 0000-0002-3738-0081 ; 0000-0002-8384-8191</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27926,27927</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38980197$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Eun-Hee</creatorcontrib><creatorcontrib>Park, Jung-Bin</creatorcontrib><creatorcontrib>Kang, Pyoyoon</creatorcontrib><creatorcontrib>Ji, Sang-Hwan</creatorcontrib><creatorcontrib>Jang, Young-Eun</creatorcontrib><creatorcontrib>Lee, Ji-Hyun</creatorcontrib><creatorcontrib>Kim, Jin-Tae</creatorcontrib><creatorcontrib>Kim, Hee-Soo</creatorcontrib><title>Effect of positive end expiratory pressure on non-hypoxic apnea time and atelectasis during induction of anesthesia in infant: A randomized controlled trial</title><title>Pediatric anesthesia</title><addtitle>Paediatr Anaesth</addtitle><description>This study aimed to assess the impact of positive-end-expiratory pressure (PEEP) on the non-hypoxic apnea time in infants during anesthesia induction with an inspired oxygen fraction of 0.8.
This age stratified randomized controlled trial included patients under 1 year of age. Preoxygenation was performed using an inspired oxygen fraction of 0.8 for 2 min. Inspired oxygen fraction of 0.8 was administered via a face mask with volume-controlled ventilation at a tidal volume of 6 mL.kg
, with or without 7 cmH
O of PEEP. Tracheal intubation was performed after 3 min of ventilation; however, it was disconnected from the breathing circuit. Ventilation was resumed once the pulse oximetry readings reached 95%. The primary outcome was the non-hypoxic apnea time, defined as the time from the cessation of ventilation to achieving a pulse oximeter reading of 95%. The secondary outcome measures included the degree of atelectasis assessed by ultrasonography and the presence of gastric air insufflation.
Eighty-four patients were included in the final analysis. In the positive end-expiratory pressure group, the atelectasis score decreased (17.0 vs. 31.5, p < .001; mean difference and 95% CI of 11.6, 7.5-15.6), while the non-hypoxic apnea time increased (80.1 s vs. 70.6 s, p = .005; mean difference and 95% CI of -9.4, -16.0 to -2.9), compared to the zero end-expiratory pressure group, among infants who are 6 months old or younger, not in those aged older than 6 months.
The application of positive end-expiratory pressure reduced the incidence of atelectasis and extended the non-hypoxic apnea time in infants who are 6 months old or younger. However, it did not affect the incidence of atelectasis nor the non-hypoxic apnea time in patients aged older than 6 months.</description><subject>Anesthesia - methods</subject><subject>Apnea</subject><subject>Clinical trials</subject><subject>Female</subject><subject>Humans</subject><subject>Hypoxia</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Oximetry - methods</subject><subject>Positive-Pressure Respiration - methods</subject><subject>Pulmonary Atelectasis - etiology</subject><subject>Pulmonary Atelectasis - prevention & control</subject><subject>Ventilation</subject><issn>1155-5645</issn><issn>1460-9592</issn><issn>1460-9592</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc9qFjEUxYMotlYXvoAE3NjFtPk3k4y7UloVCm7qesiX3NiUmWRMMtLPZ_FhvdraRUMgl_A7h3M5hLzl7ITjOV1tOuFqHPpn5JCrgXVjP4rnOPO-7_pB9QfkVa23jHEpBvGSHEgzGsZHfUh-X4QArtEc6JprbPEnUEiewt0ai2257OlaoNatAM2Jppy6m_2a76Kjdk1gaYsLUIsK22BGJ1tjpX4rMX2nMfnNtYg6tLcJaruBGi3-4w02tY_0jBYU5yX-Ak9dTq3kecaxlWjn1-RFsHOFNw_vEfl2eXF9_rm7-vrpy_nZVeeENK1zQWjnRyME86MIzuwE445xXFdx5QUMVnstJVil-Si0HiQMWgctnJTB7uQR-XDvu5b8Y8OY0xKrg3nGzHmrk2Rac2P4oBB9_wS9zVtJmG6SnEumTK8MUsf3lCu51gJhWktcbNlPnE1_K5uwsulfZci-e3Dcdgv4R_J_R_IPgfyTow</recordid><startdate>20241101</startdate><enddate>20241101</enddate><creator>Kim, Eun-Hee</creator><creator>Park, Jung-Bin</creator><creator>Kang, Pyoyoon</creator><creator>Ji, Sang-Hwan</creator><creator>Jang, Young-Eun</creator><creator>Lee, Ji-Hyun</creator><creator>Kim, Jin-Tae</creator><creator>Kim, Hee-Soo</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2661-7944</orcidid><orcidid>https://orcid.org/0000-0002-3738-0081</orcidid><orcidid>https://orcid.org/0000-0002-8384-8191</orcidid></search><sort><creationdate>20241101</creationdate><title>Effect of positive end expiratory pressure on non-hypoxic apnea time and atelectasis during induction of anesthesia in infant: A randomized controlled trial</title><author>Kim, Eun-Hee ; Park, Jung-Bin ; Kang, Pyoyoon ; Ji, Sang-Hwan ; Jang, Young-Eun ; Lee, Ji-Hyun ; Kim, Jin-Tae ; Kim, Hee-Soo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c238t-cf27cd98220d92fc8b201c01013414d2e6a7d733ea471927763e677f72c33fab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Anesthesia - methods</topic><topic>Apnea</topic><topic>Clinical trials</topic><topic>Female</topic><topic>Humans</topic><topic>Hypoxia</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Oximetry - methods</topic><topic>Positive-Pressure Respiration - methods</topic><topic>Pulmonary Atelectasis - etiology</topic><topic>Pulmonary Atelectasis - prevention & control</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Eun-Hee</creatorcontrib><creatorcontrib>Park, Jung-Bin</creatorcontrib><creatorcontrib>Kang, Pyoyoon</creatorcontrib><creatorcontrib>Ji, Sang-Hwan</creatorcontrib><creatorcontrib>Jang, Young-Eun</creatorcontrib><creatorcontrib>Lee, Ji-Hyun</creatorcontrib><creatorcontrib>Kim, Jin-Tae</creatorcontrib><creatorcontrib>Kim, Hee-Soo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Eun-Hee</au><au>Park, Jung-Bin</au><au>Kang, Pyoyoon</au><au>Ji, Sang-Hwan</au><au>Jang, Young-Eun</au><au>Lee, Ji-Hyun</au><au>Kim, Jin-Tae</au><au>Kim, Hee-Soo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of positive end expiratory pressure on non-hypoxic apnea time and atelectasis during induction of anesthesia in infant: A randomized controlled trial</atitle><jtitle>Pediatric anesthesia</jtitle><addtitle>Paediatr Anaesth</addtitle><date>2024-11-01</date><risdate>2024</risdate><volume>34</volume><issue>11</issue><spage>1146</spage><epage>1153</epage><pages>1146-1153</pages><issn>1155-5645</issn><issn>1460-9592</issn><eissn>1460-9592</eissn><abstract>This study aimed to assess the impact of positive-end-expiratory pressure (PEEP) on the non-hypoxic apnea time in infants during anesthesia induction with an inspired oxygen fraction of 0.8.
This age stratified randomized controlled trial included patients under 1 year of age. Preoxygenation was performed using an inspired oxygen fraction of 0.8 for 2 min. Inspired oxygen fraction of 0.8 was administered via a face mask with volume-controlled ventilation at a tidal volume of 6 mL.kg
, with or without 7 cmH
O of PEEP. Tracheal intubation was performed after 3 min of ventilation; however, it was disconnected from the breathing circuit. Ventilation was resumed once the pulse oximetry readings reached 95%. The primary outcome was the non-hypoxic apnea time, defined as the time from the cessation of ventilation to achieving a pulse oximeter reading of 95%. The secondary outcome measures included the degree of atelectasis assessed by ultrasonography and the presence of gastric air insufflation.
Eighty-four patients were included in the final analysis. In the positive end-expiratory pressure group, the atelectasis score decreased (17.0 vs. 31.5, p < .001; mean difference and 95% CI of 11.6, 7.5-15.6), while the non-hypoxic apnea time increased (80.1 s vs. 70.6 s, p = .005; mean difference and 95% CI of -9.4, -16.0 to -2.9), compared to the zero end-expiratory pressure group, among infants who are 6 months old or younger, not in those aged older than 6 months.
The application of positive end-expiratory pressure reduced the incidence of atelectasis and extended the non-hypoxic apnea time in infants who are 6 months old or younger. However, it did not affect the incidence of atelectasis nor the non-hypoxic apnea time in patients aged older than 6 months.</abstract><cop>France</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38980197</pmid><doi>10.1111/pan.14965</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2661-7944</orcidid><orcidid>https://orcid.org/0000-0002-3738-0081</orcidid><orcidid>https://orcid.org/0000-0002-8384-8191</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Pediatric anesthesia, 2024-11, Vol.34 (11), p.1146-1153 |
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| subjects | Anesthesia - methods Apnea Clinical trials Female Humans Hypoxia Infant Infant, Newborn Male Oximetry - methods Positive-Pressure Respiration - methods Pulmonary Atelectasis - etiology Pulmonary Atelectasis - prevention & control Ventilation |
| title | Effect of positive end expiratory pressure on non-hypoxic apnea time and atelectasis during induction of anesthesia in infant: A randomized controlled trial |
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