Effect of High-Flow Nasal Oxygen on Laryngoscopic View
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: HFNO flow 0, HFNO flow 40, HFNO 60.
- Who it may be relevant to
- Registry conditions: High Flow Nasal Canula, Laryngoscopy, Airway Anesthesia, Airway Complication of Anaesthesia. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Effect of Different Flows Using High-Flow Nasal Oxygen (HFNO) on Laryngoscopic View Quality During Videolaryngoscopy
Overview
This prospective, multicenter observational study aims to evaluate the effect of different flow rates of high-flow nasal oxygen (HFNO) on the quality of the laryngoscopic view during videolaryngoscopy in adult patients undergoing general anesthesia. Each patient will serve as their own control, with repeated measurements obtained at three different HFNO flow settings (0, 40, and 60 L/min). The study will assess objective and subjective parameters of glottic visualization using standardized scoring systems.
Detailed description
Anaesthetic management Anaesthesia induction and airway management will be standardized as far as clinically feasible. Standard monitoring will be applied according to institutional practice. Preoxygenation will be performed using high-flow nasal oxygen (HFNO). General anaesthesia will be induced using standard intravenous agents, followed by administration of neuromuscular blockade to facilitate laryngoscopy. Mask ventilation will be performed as clinically indicated.
Videolaryngoscopy will be performed using a standardized device and blade type whenever possible. All procedures will be performed by anesthesiologists experienced in videolaryngoscopy.
Study procedure
After induction of anaesthesia and achievement of adequate conditions for laryngoscopy, videolaryngoscopy will be performed. During a single laryngoscopic sequence, images of the laryngeal view will be obtained under three predefined HFNO flow conditions:
* 0 L/min * 40 L/min * 60 L/min At each flow level, once a stable laryngeal view will be achieved, a still image will be captured using the videolaryngoscope recording system. The laryngoscope position will be maintained as stable as possible during acquisition of all three images. No attempt at tracheal intubation will be made during image acquisition.
After completion of the image capture protocol, tracheal intubation will be performed according to standard clinical practice.
All images will be anonymized and stored for subsequent offline analysis. Image assessment Captured images will be evaluated offline by an independent anesthesiologist blinded to HFNO flow rates and patient identity. Where applicable, evaluation will be performed by more than one assessor to allow assessment of inter-rater agreement.
Each image will be assessed using predefined objective and subjective measures (Percentage of Glottic Opening, Likert scale).
Interventions
- Device HFNO flow 0
Different flows will be applied to patients undergoing general anaesthesia during airway management. In this arm flow will be 0 l/min. During these flows images will be captured using videolaryngoscope. - Device HFNO flow 40
Different flows will be applied to patients undergoing general anaesthesia during airway management. In this arm flow will 40 l/min. During these flows images will be captured using videolaryngoscope. - Device HFNO 60
Different flows will be applied to patients undergoing general anaesthesia during airway management. In this arm flow will 60 l/min. During these flows images will be captured using videolaryngoscope.
Primary outcome measures
- Quality of view [Time frame: From induction of general anesthesia to completion of orotracheal intubation (not longer than 10 minutes).]
Secondary outcome measures (2)
- Cormack-Lehane classification [Time frame: From induction of general anesthesia to completion of orotracheal intubation (not longer than 10 minutes).]
- Subjective image quality (Likert scale) [Time frame: From induction of general anesthesia to completion of orotracheal intubation (not longer than 10 minutes).]
Eligibility criteria
Inclusion criteria
- Age ≥18 years
- Scheduled for endotracheal intubation under general anesthesia
- Use of videolaryngoscopy
Exclusion criteria
- Anticipated difficult airway
- Emergency intubation
- Contraindications to HFNO
- Inability to obtain adequate video recording
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Case-control
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07575776 · HFNORCT