Acute Dyspnea, Dyspnea
Conditions
Keywords
Acute dyspnea, Emergency department, Dyspnea, Congestion, Proof-of-concept study, GapCO2
Brief summary
Patients presenting to the emergency department with acute dyspnea undergo arterial blood gas measurement and monitoring of transcutaneous capnography using the TCM5 monitor. The aim of this study is to determine whether GapCO2, the difference between transcutaneous and arterial pCO2 (PaCO2 - PtcCO2), is correlated with the congestive or non-congestive origin of dyspnea.
Detailed description
Upon arrival at the emergency department, patients are placed in the vital emergency reception area for monitoring. An emergency physician will review the selection criteria and offer the patient participation. The information sheet will be provided to the patient along with a copy of the non-opposition form in case of patient agreement. Before the introduction of any treatment, a TC 92 sensor is placed on the earlobe (or on the forehead if the earlobe is inaccessible), connected to a Radiometer TCM5 monitor, measuring SpO2 (Massimo technology), perfusion index, and transcutaneous capnography (PtcCO2). After a 5-minute equilibration period, measurements were taken throughout the duration of patient management. Standard diagnostic and therapeutic management will be provided according to the attending physician's prescription. The attending physician won't consider PtcCO2 (nor GapCO2) measurements in patient management. At the time of data analysis, an adjudication committee comprising 2 emergency physicians from the inclusion service but not involved in patient care will review the complete medical records of patients to determine whether dyspnea was of congestive or non-congestive origin.
Interventions
None listed
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Patient presenting with acute dyspnea defined by a sensation of respiratory discomfort with at least one of the following criteria: RR ≥ 22 and/or SpO2 \< 95% * Arterial blood gas sampling performed as part of care * Inclusion less than 1 hour after arrival time to the emergency department * Non-opposition to participation in the study
Exclusion criteria
* Temperature greater than or equal to 37.5°C * Patient who has already received a diuretic or vasodilator treatment in the emergency department or by a prehospital medical team * Systolic blood pressure less than or equal to 100 mmHg and/or signs of peripheral hypoperfusion * Inability to express refusal to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| GapCO2 | Within 1 hour after enrolment | PaCO2 measured via arterial blood gas analysis - PtcCO2 measured via TCM5 monitor, at 37°C |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diagnostic performance of GapCO2 at 37°C | Within 1 hour after enrolment | — |
| Proportion of patients who underwent GapCO2 measurement among those who presented to the emergency department for dyspnea on the days of inclusion | up to 28 days | Feasibility of measuring GapCO2 in the emergency department |
Countries
France
Contacts
CONTACTJudith GORLICKI, MD
CONTACTFrédéric ADNET, MD-PhD
PRINCIPAL_INVESTIGATORJudith GORLICKI, MD
Assistance Publique - Hôpitaux de Paris
Outcome results
None listed