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Continuous positive airway pressure to reduce the risk of early peripheral oxygen desaturation after onset of apnoea in children: A double-blind randomised controlled trial

Continuous positive airway pressure (CPAP) during anaesthesia induction improves oxygen saturation (SpO(2)) outcomes in adults subjected to airway manipulation, and could similarly support oxygenation in children. We evaluated whether CPAP ventilation and passive CPAP oxygenation in children would d...

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Autores principales: dos Santos Neto, Jayme Marques, de Carvalho, Clístenes Cristian, de Andrade, Lívia Barboza, Dos Santos, Thiago Gadelha Batista, Andrade, Rebeca Gonelli Albanez da Cunha, Fernandes, Raphaella Amanda Maria Leite, de Orange, Flavia Augusta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486132/
https://www.ncbi.nlm.nih.gov/pubmed/34597324
http://dx.doi.org/10.1371/journal.pone.0256950
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author dos Santos Neto, Jayme Marques
de Carvalho, Clístenes Cristian
de Andrade, Lívia Barboza
Dos Santos, Thiago Gadelha Batista
Andrade, Rebeca Gonelli Albanez da Cunha
Fernandes, Raphaella Amanda Maria Leite
de Orange, Flavia Augusta
author_facet dos Santos Neto, Jayme Marques
de Carvalho, Clístenes Cristian
de Andrade, Lívia Barboza
Dos Santos, Thiago Gadelha Batista
Andrade, Rebeca Gonelli Albanez da Cunha
Fernandes, Raphaella Amanda Maria Leite
de Orange, Flavia Augusta
author_sort dos Santos Neto, Jayme Marques
collection PubMed
description Continuous positive airway pressure (CPAP) during anaesthesia induction improves oxygen saturation (SpO(2)) outcomes in adults subjected to airway manipulation, and could similarly support oxygenation in children. We evaluated whether CPAP ventilation and passive CPAP oxygenation in children would defer a SpO(2) decrease to 95% after apnoea onset compared to the regular technique in which no positive airway pressure is applied. In this double-blind, parallel, randomised controlled clinical trial, 68 children aged 2–6 years with ASA I–II who underwent surgery under general anaesthesia were divided into CPAP and control groups (n = 34 in each group). The intervention was CPAP ventilation and passive CPAP oxygenation using an anaesthesia workstation. The primary outcome was the elapsed time until SpO(2) decreased to 95% during a follow-up period of 300 s from apnoea onset (T1). We also recorded the time required to regain baseline levels from an SpO(2) of 95% aided by positive pressure ventilation (T2). The median T1 was 278 s (95% confidence interval [CI]: 188–368) in the CPAP group and 124 s (95% CI: 92–157) in the control group (median difference: 154 s; 95% CI: 58–249; p = 0.002). There were 17 (50%) and 32 (94.1%) primary events in the CPAP and control groups, respectively. The hazard ratio was 0.26 (95% CI: 0.14–0.48; p<0.001). The median for T2 was 21 s (95% CI: 13–29) and 29 s (95% CI: 22–36) in the CPAP and control groups, respectively (median difference: 8 s; 95% CI: -3 to 19; p = 0.142). SpO(2) was significantly higher in the CPAP group than in the control group throughout the consecutive measures between 60 and 210 s (with p ranging from 0.047 to <0.001). Thus, in the age groups examined, CPAP ventilation and passive CPAP oxygenation deferred SpO(2) decrease after apnoea onset compared to the regular technique with no positive airway pressure.
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spelling pubmed-84861322021-10-02 Continuous positive airway pressure to reduce the risk of early peripheral oxygen desaturation after onset of apnoea in children: A double-blind randomised controlled trial dos Santos Neto, Jayme Marques de Carvalho, Clístenes Cristian de Andrade, Lívia Barboza Dos Santos, Thiago Gadelha Batista Andrade, Rebeca Gonelli Albanez da Cunha Fernandes, Raphaella Amanda Maria Leite de Orange, Flavia Augusta PLoS One Research Article Continuous positive airway pressure (CPAP) during anaesthesia induction improves oxygen saturation (SpO(2)) outcomes in adults subjected to airway manipulation, and could similarly support oxygenation in children. We evaluated whether CPAP ventilation and passive CPAP oxygenation in children would defer a SpO(2) decrease to 95% after apnoea onset compared to the regular technique in which no positive airway pressure is applied. In this double-blind, parallel, randomised controlled clinical trial, 68 children aged 2–6 years with ASA I–II who underwent surgery under general anaesthesia were divided into CPAP and control groups (n = 34 in each group). The intervention was CPAP ventilation and passive CPAP oxygenation using an anaesthesia workstation. The primary outcome was the elapsed time until SpO(2) decreased to 95% during a follow-up period of 300 s from apnoea onset (T1). We also recorded the time required to regain baseline levels from an SpO(2) of 95% aided by positive pressure ventilation (T2). The median T1 was 278 s (95% confidence interval [CI]: 188–368) in the CPAP group and 124 s (95% CI: 92–157) in the control group (median difference: 154 s; 95% CI: 58–249; p = 0.002). There were 17 (50%) and 32 (94.1%) primary events in the CPAP and control groups, respectively. The hazard ratio was 0.26 (95% CI: 0.14–0.48; p<0.001). The median for T2 was 21 s (95% CI: 13–29) and 29 s (95% CI: 22–36) in the CPAP and control groups, respectively (median difference: 8 s; 95% CI: -3 to 19; p = 0.142). SpO(2) was significantly higher in the CPAP group than in the control group throughout the consecutive measures between 60 and 210 s (with p ranging from 0.047 to <0.001). Thus, in the age groups examined, CPAP ventilation and passive CPAP oxygenation deferred SpO(2) decrease after apnoea onset compared to the regular technique with no positive airway pressure. Public Library of Science 2021-10-01 /pmc/articles/PMC8486132/ /pubmed/34597324 http://dx.doi.org/10.1371/journal.pone.0256950 Text en © 2021 dos Santos Neto et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
dos Santos Neto, Jayme Marques
de Carvalho, Clístenes Cristian
de Andrade, Lívia Barboza
Dos Santos, Thiago Gadelha Batista
Andrade, Rebeca Gonelli Albanez da Cunha
Fernandes, Raphaella Amanda Maria Leite
de Orange, Flavia Augusta
Continuous positive airway pressure to reduce the risk of early peripheral oxygen desaturation after onset of apnoea in children: A double-blind randomised controlled trial
title Continuous positive airway pressure to reduce the risk of early peripheral oxygen desaturation after onset of apnoea in children: A double-blind randomised controlled trial
title_full Continuous positive airway pressure to reduce the risk of early peripheral oxygen desaturation after onset of apnoea in children: A double-blind randomised controlled trial
title_fullStr Continuous positive airway pressure to reduce the risk of early peripheral oxygen desaturation after onset of apnoea in children: A double-blind randomised controlled trial
title_full_unstemmed Continuous positive airway pressure to reduce the risk of early peripheral oxygen desaturation after onset of apnoea in children: A double-blind randomised controlled trial
title_short Continuous positive airway pressure to reduce the risk of early peripheral oxygen desaturation after onset of apnoea in children: A double-blind randomised controlled trial
title_sort continuous positive airway pressure to reduce the risk of early peripheral oxygen desaturation after onset of apnoea in children: a double-blind randomised controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486132/
https://www.ncbi.nlm.nih.gov/pubmed/34597324
http://dx.doi.org/10.1371/journal.pone.0256950
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