Reducing Pain in Emergency Department by Using Veinous Blood Gas Instead of Arterious Blood Gas

NCT03784664 | Completed

• 1 other identifier: Assistance Publique - Hôpitaux
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 4

Brief Summary

Blood gases are widely used in emergency and resuscitation services and are the key examination for exploring acid-base balance disorders (using pH, PaCO2 and HCO3 ) and gas exchange disorders (using PaO2 and PaCO2). This examination can be taken from both venous and arterial sample and its analysis depends on the type of blood sample. Currently, several studies have already shown the existence of a good correlation of pH and bicarbonates level between a venous and arterial sample. Thus, when this examination is prescribed for the purpose of highlighting and analyzing an acid-base disorder, venous blood gas is theoretically as efficient as arterial blood gas. Due to the lack of evidence of benefit for the patient or the health care team of a venous blood gas rather than an arterial blood gas in the absence of suspicion of hypoxemia, arterial blood gas is currently the standard of care for the analysis of acid-base disorders. Indeed, among the university hospitals affiliated to the Paris Diderot University, the emergency departments carry out in their vast majority (4 of 5 E.D.) arterial blood gases. Demonstration of the superiority of veinous sample over arterial sample regarding pain could substantially modify current practices. The investigator's main hypothesis is that, in the absence of suspicion of hypoxemia (normal oxygen saturation measured by plethysmography), the realization of a venous blood gas for the evaluation of the acid-base balance in the context of emergencies is less painful for patients, simpler for the health care team and provides sufficient biochemical information for the doctor in comparison with an arterial blood gas.

Conditions

Acid Base Disorder

Outcome Measures

Primary Outcomes (1)

• Pain score: Visual Analog Scale

  Pain is self-completed by the patient using a Visual Analog Scale. Visual Analog Scale for Pain is a continuous scale comprised of a line of 100 mm grading pain intensity anchored by "no pain" (score 0) and "worst imaginable pain" (score 100)

  Immediately after blood gas sample

Secondary Outcomes (5)

• Number of attempts needed to obtain a blood gas sample

  Immediately after blood gas sample

• Number of different operators needed to obtain a blood gas sample

  Immediately after blood gas sample

• Ease of blood gas sampling procedure

  Immediately after blood gas sample

• Failure of the blood gas sampling procedure

  Immediately after blood gas sample

• Quality of information provided by the blood gas analysis: four levels likert scale

  Immediately after having received blood gas analysis results

Study Arms (2)

Arterial blood gas

ACTIVE COMPARATOR

Diagnostic Test: Arterial blood gas

Veinous blood gas

EXPERIMENTAL

Diagnostic Test: Veinous blood gas

Interventions

Arterial blood gas DIAGNOSTIC_TEST

arterial blood sample with puncture of the radial artery

Arterial blood gas

Veinous blood gas DIAGNOSTIC_TEST

veinous blood sample using peripheral venepuncture

Veinous blood gas

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• necessity of blood gas analysis
• age \> 18 yo
• SpO2\>95% without supplemental oxygen
• no altered level of consciousness: Glasgow Coma Scale=15

You may not qualify if:

• Patient under guardianship or curatorship
• confusional state or patient unable to understand the protocol
• no social security

Sponsors & Collaborators

• Assistance Publique - Hôpitaux de Paris: lead

Study Sites (4)

Hôpital Beaujon

Clichy, 92110, France

Location

Hôpital Louis Mourier

Colombes, 95700, France

Location

Hôpital Lariboisière

Paris, 75010, France

Location

Hôpital Bichat

Paris, 75018, France

Location

Related Publications (1)

• Chauvin A, Javaud N, Ghazali A, Curac S, Altar A, Ali T, Beguin N, Bellier J, Coupier A, Delsarte L, Dreyfuss D, Kheirbek N, Oudar C, Stordeur Y, Weiss M, Gaudry S, Lambert J, Roux D. Reducing pain by using venous blood gas instead of arterial blood gas (VEINART): a multicentre randomised controlled trial. Emerg Med J. 2020 Dec;37(12):756-761. doi: 10.1136/emermed-2019-209287. Epub 2020 Aug 5.

  PMID: 32759347 DERIVED

MeSH Terms

Interventions

Blood Gas Analysis

Intervention Hierarchy (Ancestors)

Blood Chemical Analysis; Clinical Chemistry Tests; Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Respiratory Function Tests; Diagnostic Techniques, Respiratory System; Investigative Techniques

Study Officials

• Damien Roux, MD,PhD

  Intensive care department, Louis Mourier hospital

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 12, 2018
• First Posted: December 24, 2018
• Study Start: January 20, 2019
• Primary Completion: March 22, 2019
• Study Completion: March 22, 2019
• Last Updated: June 19, 2019

Record last verified: 2018-12

Locations

FR (4)