- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02421250
Noninvasive Hemoglobin Monitor in the ER (SpHb)
Comparison of Accuracy and Clinical Outcomes of a Continuous Noninvasive Hemoglobin Monitor in the Emergency Room Setting
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
A major issue faced by emergency departments all over the world is overcrowding, resulting from limited resources (i.e. staff, space, equipment) attending to a large of patients that exceeds the physical and/or staffing capacity of the ED. To manage the issue of overcrowding, the system of triage was created to help prioritize each patient's case, based on set criteria to determine time to treatment and/or which treatment is indicated. Our study will contribute to the discovery of more efficient ways of triaging patients based on objective and subjective criteria for decision-making about treatment and disposition, while simultaneously maintaining patient safety.
The investigators achieve this aim by evaluating the efficiency of a noninvasive and continuous total hemoglobin (SpHb) monitor provided by Masimo Corporation (Irvine USA). Standard hemoglobin measurements via central laboratory testing are invasive, painful, time-consuming, have increased lag time for analysis, potentially expose health care workers to blood-borne illness, and delay treatment onset because they require direct blood sampling. The new SpHb monitor potentially offers a new way to evaluate objective criteria about patients to maximize treatment outcomes and appropriate dispositions. The SpHb monitor has the potential to trend hemoglobin monitoring, quicken the detection of acute anemia, and avoid the complications, anxiety, expense, and patient discomfort associated with invasive blood draws.
In the ED setting, there is a need to efficiently triage a patient and designate a disposition for appropriate treatment management and outcomes. Hemoglobin level is an accurate indicator that helps distinguish patients who need early blood transfusion and meet criteria for admission. Noninvasive technology, such as the SpHb device by Masimo, will assist with common goals in emergency medicine: to efficiently and accurately decrease wait times to treatment and disposition, screening patients who have difficult venous access, providing repeated sampling without causing iatrogenic blood loss linked to anemia, and offering an approach that may be used to develop an organized coherent therapeutic plan based on physiologic criteria for the emergency patient as he/she proceeds from the ED to the OR, the hospital general floor, and the ICU.
This study will be performed at the University of Chicago Medical Center in the main adult emergency room. Patients will be examined and enrolled into our study initially by the triage nurse after each person has given his/her written informed consent.
Randomization process will be carried out based on days of the week. Patients will be enrolled in one group every two days. For example, starting on the week when we begin the trial, we will assign Monday patients to the control group, Tuesday patients to the experimental group, Wednesday patients to the control group… Two groups are similar in characteristics. Depending on whether the subject has been randomized into the control or experimental group, we will not use or use the SpHb monitor to obtain measurements. To obtain measurements, we place the probe of the device on the patient's finger and record the hemoglobin level determined by the Masimo Radical-7 Pulse CO-Oximeter.
We will collect patient satisfaction data 2 minutes after the placement of the SpHb device and 2 minutes after the blood sampling. The collection of blood is considered standard of care. Along with recording hemoglobin measurements, we will record triage chief complaint, final physician diagnosis, time to blood products transfusion, time to disposition (i.e. discharge home or Hospital admission via intensive care unit or general floor), time to procedure (i.e. procedure via operating room, endoscopy with interventional gastroenterology, interventional pulmonology, or ENT, or interventional radiology), and hemodynamics (i.e. blood pressure, heart rate, oxygen saturation, and respiratory rate).
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Illinois
-
Chicago, Illinois, United States, 60615
- University of Chicago
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria: The following is the inclusion criteria for each participant based on initial complaints in triage of bleeding:
- GI bleeding-melena, hematochezia, hematemesis
- Vaginal bleeding
- Epistaxis
- Hematuria
- Hemoptysis
- Sickle cell patients
- Bleeding from recent surgical procedure
- Dizziness or lightheadedness in LVAD patients or hematology and oncology patients (i.e. cancer, leukemia, lymphoma-currently receiving chemo, stem cell treatment, or bone marrow transplant).
Exclusion Criteria:
- Exclusion criteria would consist of those patients in critically ill condition i.e. trauma, those needing massive transfusion protocol, cardiac arrest with active CPR, active seizure, hypothermia, acute intoxication/AMS that prohibits cooperation or following commands
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Radical-7 Non-invasive Hgb Monitor
We use the Radical-7 Noninvasive Hgb Monitor device (provided by Masimo Corporation from Irvine USA) to measure hemoglobin levels in patients in the experimental group.
|
|
No Intervention: Control
We will use standard-of-care for control group and not use the SpHb monitor.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Hemoglobin Measurements
Time Frame: During intervention period (8 weeks)
|
Hemoglobin level to be measured once at triage; hgb measurements (g/dL)
|
During intervention period (8 weeks)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to procedure
Time Frame: During intervention period (8 weeks)
|
Measured in minutes; i.e. procedure via operating room, endoscopy with interventional gastroenterology, interventional pulmonology, or ENT, or interventional radiology
|
During intervention period (8 weeks)
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to disposition
Time Frame: During intervention period (8 weeks)
|
Measured in minutes
|
During intervention period (8 weeks)
|
Time to blood transfusion
Time Frame: During intervention period (8 weeks)
|
Measured in minutes
|
During intervention period (8 weeks)
|
Hemodynamics
Time Frame: During intervention period (8 weeks)
|
i.e. blood pressure, heart rate, oxygen saturation, and respiratory rate
|
During intervention period (8 weeks)
|
Triage chief complaint
Time Frame: During intervention period (8 weeks)
|
Reason for visiting the ER
|
During intervention period (8 weeks)
|
Final physician diagnosis
Time Frame: During intervention period (8 weeks)
|
During intervention period (8 weeks)
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Thomas Spiegel, MD MBA, University of Chicago
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- IRB15-0167
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Hemoglobin
-
Karabuk UniversityCompletedHemoglobin Level Measurement | Hemoglobin Level EstimationTurkey
-
China Medical University HospitalNational Science and Technology Council; SEHA Kidney Care; Asia University HospitalRecruiting
-
MYOR Ltd.CompletedHemoglobin; DeficiencyIsrael
-
Centre Hospitalier Universitaire de Saint EtienneClaude Bernard University; Laboratoire de Physiologie de l'Exercice; Centre de...CompletedHemoglobin S Disease | Sickle Cell Hemoglobin C DiseaseFrance
-
Seoul National University HospitalCompletedContinuous Hemoglobin MeasurementKorea, Republic of
-
University of British ColumbiaMasimo CorporationCompletedHemoglobin Levels in BloodCanada
-
Emory UniversityPatient-Centered Outcomes Research InstituteCompletedSickle Cell Disease | Sickle Cell Anemia | Hemoglobin SC | Hemoglobin SS | Hemoglobin Beta ThalassemiaUnited States
-
University of California, DavisCompletedAccuracy of Non-invasive Hemoglobin Monitor
-
University of California, DavisRecruitingSurgery | HemoglobinUnited States
-
OneBlood, Inc.OrSense, Ltd.Completed
Clinical Trials on Radical-7 Noninvasive Hgb Monitor
-
Tampere University HospitalCompletedArrhythmias, Cardiac | Blood PressureFinland
-
University of CincinnatiRecruitingPulmonary Arterial HypertensionUnited States
-
Noninvasive Medical Technologies, Inc.University of Florida; Shand's Medical CenterCompletedHeart Failure | Hypertension | Trauma | Dyspnea | Pacemaker
-
National Taiwan University HospitalCompletedCholangiopancreatography, Endoscopic Retrograde | Endoscopic UltrasonographyTaiwan
-
Città di Roma HospitalUnknownDelivery UterineItaly
-
Pamela PetersenCompleted
-
Lady Davis InstituteCarebook Technologies Inc.UnknownVascular Diseases | Coronavirus | Respiratory Disease | Cardiac Disease
-
Brigham and Women's HospitalSuspendedObstetric Anesthesia, Cardiac MonitoringUnited States
-
Manisa Celal Bayar UniversityCompleted
-
Society for the Advancement of Blood Management...UnknownSurgeryUnited States, France, Italy, Japan