- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04245553
Does Point of Care Ultrasound Change Needle Insertion Location During Routine Bedside Paracentesis?
April 2, 2024 updated by: Steven Montague
Paracentesis is a bedside procedure in which a needle is inserted into a patient's peritoneum in order to obtain ascitic fluid.
This is a safe bedside procedure with very low risks of complications that is usually performed using physical exam maneuvers to determine the site of needle insertion.
Point of care ultrasound (POCUS) technology has improved the safety of central venous catheter insertion and thoracentesis, yet the data on safety in paracentesis is equivocal.
In a practical study, we aim to determine if POCUS will change the needle insertion site over the traditional anatomic landmarking method.
Operators will landmark for paracentesis using conventional physical exam and then utilize POCUS to determine if there is a more optimal site.
The primary endpoint will be whether POCUS yielded a change in the needle insertion site, as defined by a location greater than 5cm from the anatomic site, at least 20% of the time.
The results will further our understanding of POCUS in improving procedural safety, thereby adding to the currently limited literature on this topic.
Furthermore, this study will inform residency training programs about the utility in POCUS training for paracentesis and may advocate for the availability of POCUS devices to physicians performing this procedure.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
45
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Ontario
-
Kingston, Ontario, Canada, K7K2V7
- Kingston Health Sciences Center
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
19 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
This is in effort to capture routine paracentesis cases.
Inclusion Criteria:
- Participants scheduled to have either a diagnostic of therapeutic paracentesis.
- Participants can be either inpatients under the care of general internal medicine, or outpatients under the care of gastroenterology or general internal medicine.
- Operators will be recruited on a volunteer basis and will include medical residents or subspecialty fellows with knowledge of POCUS for paracentesis purposes, either through core residency programs or more advanced training.
Exclusion Criteria:
- Loculated ascites
- Current anticoagulation
- Hemodynamic instability
- Bowel obstruction
- Pregnancy
- Abdominal wall cellulitis
- Platelet count <20
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: All Participants
|
Participants will be have their needle insertion site for a paracentesis land-marked using both the traditional anatomical method, and with a point of care ultrasound.
Note that the current standard of care does not require the use of point of care ultrasound.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Preference of land-marking method
Time Frame: Determined immediatly after the POCUS landmarking is done.
|
Does the clinician performing the procedure prefer the needle insertion site found using point of care ultrasound, or using the traditional anatomic method.
A clinically significant difference in location is defined as greater than or equal to 5cm apart.
If the difference in locations is not at least 5cm apart, this will be defined as no preference in land-marking methods.
|
Determined immediatly after the POCUS landmarking is done.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Depth of Ascitis
Time Frame: Determined immediatly after the POCUS landmarking is done.
|
Depth of ascitis, measured perpendicular to the overlying skin, at the location land-marked using traditional anatomic method, versus the location found with point of care ultrasound.
|
Determined immediatly after the POCUS landmarking is done.
|
Immediate Complications
Time Frame: Occuring at any time between the needle insertion and removal of the paracentesis drain.
|
The overall rate of any complications observed while performing the procedure.
This includes bleeding, perforation/puncture of any internal organ, or a failed attempt.
|
Occuring at any time between the needle insertion and removal of the paracentesis drain.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Steven Montague, MD, Queen's University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 7, 2020
Primary Completion (Actual)
March 1, 2021
Study Completion (Actual)
March 1, 2021
Study Registration Dates
First Submitted
January 25, 2020
First Submitted That Met QC Criteria
January 25, 2020
First Posted (Actual)
January 29, 2020
Study Record Updates
Last Update Posted (Actual)
April 3, 2024
Last Update Submitted That Met QC Criteria
April 2, 2024
Last Verified
April 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 6028481
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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.
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