The primary objective of this study is to test the hypothesis that treatment of patients with respiratory complaints in the emergency department (ED) based on venous blood gas (VBG) results does not differ from treatment based on arterial blood gas…
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Brief title
Condition
- Other condition
Synonym
Health condition
Respiratoire klachten veroorzaakt door verschillende onderliggende ziektebeelden
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The main study endpoint is the frequency of alterations in treatment of
patients with respiratory complaints in the emergency department (ED) based on
venous blood gas (VBG) results compared to treatment based on arterial blood
gas (ABG) results. We will assess which alterations in treatment occur, the
characteristics of alterations and which ABG results cause the change.
Secondary outcome
Secondary endpoints are the agreement between venous and arterial pH,
bicarbonate, pCO2, lactate and pO2 and the correlation between venous and
arterial pO2 and the peripheral oxygen saturation measured with pulse oximetry.
Background summary
An integral part of the assessment of patients with respiratory complaints in
the emergency department (ED) is determining the acid-base, ventilation and
oxygenation status. Traditionally, arterial blood gas (ABG) results (the
reference standard) have been used. ABG sampling is often painful, can be
challenging to perform, and carries risks.
Previous research shows venous blood gas (VBG) results are a reliable
alternative with a good correlation between venous and arterial pH and
bicarbonate. Venous carbon dioxide partial pressure (pCO2) and venous lactate
can also be used as a reliable screening method for arterial hypercapnia and
hyperlactatemia. In addition, the development and widespread use of pulse
oximetry makes it easy to determine the oxygenation status of patients. Despite
the evidence, arterial blood gas sampling remains the common method of
determining acid-base, ventilation and oxygenation status in patients with
respiratory complaints in the ED.
Study objective
The primary objective of this study is to test the hypothesis that treatment of
patients with respiratory complaints in the emergency department (ED) based on
venous blood gas (VBG) results does not differ from treatment based on arterial
blood gas (ABG) results. We will assess the frequency of alterations in
treatment based on VBG results compared to treatment based on ABG results.
Which alterations in treatment occur, the characteristics of the alterations
and the ABG results causing the change (pH, bicarbonate, pCO2, lactate or pO2)
will be assessed.
Study design
Prospective cohort study.
Study burden and risks
Patients will undergo venepuncture or peripheral venous catheter placement and
arterial blood gas (ABG) sampling as part of standard care. One extra blood
sample will be obtained with the standard venepuncture or from the peripheral
venous catheter to collect the venous blood gas (VBG). No extra vascular
puncture is required. Treatment is according to current guidelines.
Henri Dunantstraat 5
Heerlen 6419 PC
NL
Henri Dunantstraat 5
Heerlen 6419 PC
NL
Listed location countries
Age
Inclusion criteria
Patients (* 18 years) presenting in the ED with dyspnoea, respiratory rate >
20/min or peripheral oxygen saturation < 95%, a reliable saturation measured by
pulse oximetry (measured with the Philips IntelliVue MP30 patient monitor, a
reliable measurement is defined by pulsatile flow with a perfusion indicator
value above 0.3) and an indication, determined by the treating physician, to
determine the acid-base, ventilation and oxygenation status by arterial blood
gas.
Exclusion criteria
A potential subject who meets any of the following criteria will be excluded
from participation in this study:
- Not capable to give informed consent within reasonable time after
stabilisation and abating of the accompanying psychological stress, and no
representative available to give informed consent on behalf of the patient.
- Arterial blood gas results are required for other reasons than determining
the acid-base, ventilation and oxygenation status, such as determining the
alveolar to arterial oxygen gradient (A-a gradient).
- No physician or qualified nurse available for ABG sampling.
- Failed ABG or VBG sampling after two attempts.
- Previous participation in the study.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL70394.096.19 |