The Physiologically Difficult Airway.
Jarrod M Mosier, Raj Joshi, Cameron Hypes...
https://pubmed.ncbi.nlm.nih.gov/26759664Actively Recruiting
Led by Kanuni Sultan Suleyman Training and Research Hospital · Updated on 2026-02-02
140
Participants Needed
4
Research Sites
4 weeks
Total Duration
Researchers are comparing two methods of helping adult patients breathe using a tube placed in the airway during emergency care. The study focuses on adults who are breathing on their own but need intubation for medical reasons not related to injury. It aims to evaluate oxygen levels, vital signs, procedure success, blood gas results, complications, and early survival following the intubation procedures. This large, multicenter randomized trial uses unique methods like measuring end-tidal CO2 for tube placement confirmation and assessing intubation difficulty with a specific classification system. The study compares Delayed Sequence Intubation (DSI) and Rapid Sequence Intubation (RSI). In DSI, patients receive ketamine to achieve sedation while preserving breathing, followed by preoxygenation and paralysis with rocuronium before intubation. In RSI, patients are preoxygenated first, then given ketamine and rocuronium sequentially before intubation. Both use direct laryngoscopy, and ventilator settings are standardized. Physiological data are recorded throughout the procedures by designated physicians. Participants will be monitored for oxygen levels, blood pH, carbon dioxide, bicarbonate, base excess, lactate levels, and survival rates at various times before, during, and after intubation. The number of intubation attempts and procedure duration are also tracked. Data collection occurs from hospital admission through 28 days post-procedure, with close monitoring of complications and vital signs to assess safety and outcomes during and after intubation.
CONDITIONS
Comparison of Peri-intubation Oxygenation Values and Complications in Patients Intubated With the Delayed Versus Rapid Sequence Intubation Protocols
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Single procedure with monitoring during and up to 1 hour after intubation
Participants receive either Delayed Sequence Intubation or Rapid Sequence Intubation protocols involving sedation, preoxygenation, paralysis, and endotracheal intubation while physiological parameters are recorded.
1 procedure visit and monitoring for 1 hour post-intubation
Duration - 28 days after intubation
Participants are monitored for safety outcomes including survival up to 28 days after intubation.
Follow-up assessments up to 28 days post-intubation
Total: 4 locations
1
Basaksehir Cam and Sakura City Hospital
Istanbul, Istanbul, Turkey (Türkiye), 34170
Actively Recruiting
2
İstanbul Haseki Training and Research Hospital
Istanbul, Turkey (Türkiye)
Actively Recruiting
3
Kanuni Sultan Süleyman Research and Training Hospital
Istanbul, Turkey (Türkiye)
Actively Recruiting
4
Şişli Hamidiye Etfal Training and Research Hospital
Istanbul, Turkey (Türkiye)
Actively Recruiting
U
Utku Murat Kalafat, Associate Professor
M
Muhammed Güner, Doctor
Study Type
INTERVENTIONAL
Masking
TRIPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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