MAsk VEntilation With Paratracheal Pressure In Children. Para Tracheal Compression to Prevent Gastric Insufflation in Children
Para Tracheal Compression to Prevent Gastric Insufflation During Positive Pressure Ventilation With Facemask in Children Under General Anaesthesia: an Efficiency Study
University Hospital, Lille
72 participants
Jun 6, 2024
INTERVENTIONAL
Conditions
Summary
The use of cricoid pressure to prevent gastric aspiration or regurgitation in case of "full stomach" situation or emergency is still controversial in the adult population. Moreover this maneuver is no more recommended in children by some European pediatric anesthesia societies, because of a lack of evidence of its protective effect against gastric aspiration and its possible adverse effects. A new approach to occlude effectively the esophageal lumen has been recently described in adults and has shown its effectiveness to prevent gastric insufflation. But this maneuver has so far not been evaluated in the pediatric population and could be an alternative to prevent gastro-esophageal regurgitation and pulmonary aspiration in children
Eligibility
Inclusion Criteria7
- Children from 2 to 10 years of age who benefit from general anesthesia with or without intubation
- inhalation induction
- elective surgery
- ASA status 1 or 2
- consent of the child if he/she is able to express it
- consent of both parents and/or legal guardians
- socially insured
Exclusion Criteria11
- Child under 2 years old or \> 10 years
- body weight is over 40 kgs
- ASA status 3 or higher
- Emergency surgery or unscheduled surgery
- scheduled ENT or esogastric surgery
- Achalasia of the esophagus or history of GERD pathology
- History of esophageal surgery (NISSEN type)
- BMI indexed to age and sex showing childhood obesity
- Predictable mask ventilation difficulties
- History of Tracheostomy
- Child not insured by social security
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Interventions
Pressure will be applied with two fingers in the area located between the trachea and the sternal head of the sternocleidomastoid muscle on the left side to compress the cervical esophagus. The force applied (after measuring the equivalent force applied on a precision scale) will be about 10 - 15 N. This force will be adapted according to the child's body weight : 10 N below 20 kgs and 15 N between 20 kgs and 40 kgs
Locations(2)
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NCT05279170