None listed
Conditions
Brief summary
Intensive care patients require many blood tests. Each blood test requires a small amount of blood loss and when added together this can lead to anaemia and the need for a blood transfusion. ICU blood tests are taken through a drip, and an amount of blood must be wasted each time, to clear the drip set and access the patient’s blood. This “discard volume” is important: too little and the blood tests may be inaccurate, too much and the patient loses even more blood unnecessarily. The ideal discard volume for most blood tests is unknown and so hospitals and health professionals take various amounts; it is highly likely that unnecessary blood loss occurs. In our study we plan to identify the minimum discard volume required to obtain accurate results for several of the most common blood tests performed in ICUs. The laboratory scientists (assessors) performing the outcomes measures will be blinded to intervention group of each blood sample.
Interventions
The study is a randomised crossover trial. Patients are randomised to a sequence of blood tests which are taken sequentially. The intervention is the size of discard volume (blood discarded to clear the line). This is calcu
The study is a randomised crossover trial. Patients are randomised to a sequence of blood tests which are taken sequentially. The intervention is the size of discard volume (blood discarded to clear the line). This is calculated as a multiple of the deadspace in the system prior to blood sampling. Six discard volumes will be tested. Each patient acts as their own control and receives each of the experiemental discard volumes. Duration: The blood sampling for the study is done on one occasion with 48 sequential blood tests (6 each of full blood count, creatinine & electrolytes, liver functions, coagulation, magnesium, troponin, calcium, & phosphate. The process will be completed within 10 minutes. Timepoint: At some stage of the intensive care admission when the patient meets the study criteria and samples can be obtained without disrupting clinical care.
Sponsors
Griffith University School of Nursing and Midwifery
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Prevention
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Informed written consent from patient or legal representative• Patent arterial catheter in situ as part of routine care • Haemoglobin >8.0g/dL• Clinically stable (has neither required nor is anticipated to require any intervention in the 30 minutes prior to, or during the sampling period).
Exclusion criteria
Current bleeding or major surgery planned in the next 48 hours• Current transfusion of blood products, hypertonic electrolytes, or anticoagulants other than heparin saline in flush devices• Patient with extracorporeal circuits• Non-English speaking patient or legal representative• Patient not expected to survive the next 24 hours or patient/relatives deemed too emotionally distressed to be approached• Inotrope support exceeding Nor-Adrenaline and Adrenaline > 5mcg/min, Dopamine and Dobutamine > 5mcg/kg/min.
Outcome results
None listed