End-Tidal Oxygen for Intubation in the Emergency Department

Recruiting now · Not applicable

Conditions studied: Critical Illness, Hypoxia, Respiratory Failure

In brief

Rapid Sequence Intubation (RSI) is a high-risk procedure in the emergency department (ED). Patients are routinely preoxygenated (given supplemental oxygen) prior to RSI to prevent hypoxia during intubation. For many years anaesthetists have used end-tidal oxygen (ETO2) levels to guide the effectiveness of preoxygenation prior to intubation. The ETO2 gives an objective measurement of preoxygenation efficacy. This is currently not available in most EDs. This trial evaluates the use of ETO2 on the rate of hypoxia during intubation for patients in the ED.

Key facts

Study ID

NCT06578468

Run by

Sydney Local Health District

People needed

1400

Starts

2024-08-05

Expected to finish

2025-12-31

Last updated by the study team

2024-09-19

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• The patient is located in the ED resuscitation bay of the participating centre.
• The planned procedure is orotracheal intubation using a laryngoscope and RSI technique with preoxygenation for patients who are spontaneously breathing.
• The patient is deemed to be at a high risk of hypoxia during RSI as per the treating ED clinician, as defined by:
• Any patient requiring any form of oxygen therapy before preoxygenation.
• Any patient with respiratory pathology based on clinical or radiological findings. Including, but not limited to:
• Pneumonia, pulmonary oedema, acute respiratory distress syndrome (ARDS), aspiration, pulmonary contusion from trauma, infective exacerbations of known lung disease (e.g. asthma, pulmonary fibrosis, emphysema) or pulmonary embolism (PE)
• Any patient with high oxygen consumption. Including, but not limited to:
• Sepsis, Diabetic ketoacidosis, alcohol or drug withdrawal, seizures, thyrotoxicosis
• Any underlying patient condition that may predispose to hypoxemia. Including, but not limited to:
• Obesity, pregnancy, underlying lung disease (e.g. asthma, pulmonary fibrosis, emphysema), severe injury- hypovolaemia/haemorrhage.
• or any other patient that the treating clinician has a high concern for hypoxemia during RSI.

You may not qualify if…

• Patient is known to be less than 18 years old.
• The patient has a supraglottic device in-situ e.g iGel or LMA.
• The patient is known to be pregnant.
• The patient is known to be a prisoner.
• The patient was intubated in the prehospital environment.
• Immediate need for tracheal intubation precludes preoxygenation i.e. the patient is in cardiac arrest.

Where it is running

• Northern Beaches Hospital — Sydney, New South Wales, Australia (enrolling)
• Royal Prince Alfred Hospital — Sydney, New South Wales, Australia (enrolling)
• Lincoln Medical Center — The Bronx, New York, United States (enrolling)
• Liverpool Hospital — Sydney, New South Wales, Australia
• Royal North Shore Hospital — Sydney, New South Wales, Australia
• Hennepin Medical Center — Minneapolis, Minnesota, United States
• The Alfred Hospital — Melbourne, Victoria, Australia
• University of New Mexico Medical Center — Albuquerque, New Mexico, United States
• Westmead Hospital — Sydney, New South Wales, Australia

Full record on ClinicalTrials.gov

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