Ultrasound Guided Versus Landmark Guided Arterial Line Placement by Emergency Medicine Interns

NCT03326739 | Completed

• 1 other identifier: 24642
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Critically ill patients in the emergency department commonly require arterial line placement for continuous direct blood pressure monitoring, frequent arterial blood gas sampling, and frequent blood sampling. Trans-radial catheterization has been shown to reduce access site complications and increase patient comfort compared to trans-femoral access. Radial artery access on the first attempt is optimal; attempts at reentry delay care and increase the risk of vascular spasm, hematoma, infection, neurovascular injury, and pain. The traditional pulse palpation method of radial artery cannulation can be challenging, especially in patients with weak pulses (i.e. morbidly obese or hypotensive individuals). A review of literature suggests that ultrasound guided trans-radial catheterization compared to standard pulse palpation reduces access time and increases rate of first-entry success when performed by physicians trained in ultrasound. Thus, complications ascribed to reentry are prevented and timely care is provided. To the investigator's knowledge, only one other prospective study has been conducted to assess the utility of ultrasound guided radial artery cannulation in the emergency department. Due to the paucity of literature to support the use of ultrasound guided trans-radial catheterization in critically ill patients, the study will aim to provide further data on the topic. Both techniques are considered standard of care.

Conditions

Vascular Access Complication

Outcome Measures

Primary Outcomes (1)

• Superiority of Method of arterial line placement

  Number of attempts until successful cannulation.

  1 day

Secondary Outcomes (1)

• Success of method

  1 day

Study Arms (2)

Ultrasound Guided A-Line Placement

ACTIVE COMPARATOR

Patients in this group will have ultrasound guided arterial line placement.

Procedure: Arterial Line Placement

Landmark Guided A-line Placement

ACTIVE COMPARATOR

Patients in this group will have landmark guided arterial line placement.

Procedure: Arterial Line Placement

Interventions

Arterial Line Placement PROCEDURE

arterial line placement

Landmark Guided A-line Placement; Ultrasound Guided A-Line Placement

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients requiring arterial line placement.

You may not qualify if:

• Adults Unable to Consent
• Members of Vulnerable Populations

Sponsors & Collaborators

• Temple University: lead

Study Sites (1)

Lewis Katz School of Medicine at Temple University

Philadelphia, Pennsylvania, 19140, United States

Location

Study Officials

• Ryan C Gibbons, MD

  Lewis Katz School of Medicine at Temple University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: CARE PROVIDER
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 17, 2017
• First Posted: October 31, 2017
• Study Start: January 1, 2017
• Primary Completion: December 31, 2019
• Study Completion: December 31, 2019
• Last Updated: January 22, 2020

Record last verified: 2020-01

Locations

US (1)