ReACT CO2
Research type
Research Study
Full title
Noninvasive Monitoring for noninvasive ventilation: Use of transcutaneous carbon dioxide monitoring to guide acute Noninvasive ventilation in patients with acute hypercapnic respiratory failure: A multi center study
IRAS ID
276018
Contact name
Milind Sovani
Contact email
Sponsor organisation
Nottingham University Hospitals NHS Trust
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Patients with breathing difficulty need arterial blood sampling to check carbon dioxide levels. This is difficult, painful, associated with complications and often met with delays. We have shown in a previous observational study, that using a skin probe to monitor carbon dioxide levels in patients with acute breathing difficulty was far more comfortable, significantly less painful and importantly closely reflected arterial carbon dioxide levels. Decisions regarding breathing support with mask (noninvasive ventilation or NIV) were however based on arterial blood samples collected simultaneously. In this feasibility study over 72 hours, patients will either have arterial blood sampling or skin probe to monitor carbon dioxide levels.
The aim of the study is to determine whether continuous carbon dioxide monitoring with a skin probe reduces the need for arterial blood sampling by at least 30%. We will also study the safety and effectiveness of skin probe monitoring to manage NIV.
Towards this we will study patients admitted with sudden worsening of breathing that has led to a build up of carbon dioxide. Patients will be recruited within 4 hours of starting NIV, preferably in the Emergency Department(ED). Their carbon dioxide levels will then be monitored by skin probe (TcCO2 group) or arterial blood gas (ABG) sampling. Clinicians can perform ABGs in TcCO2 group at their discretion.
Our main end point is the total number of ABGs performed in each group. Clinicians will complete a questionnaire for unscheduled ABGs in TcCO2 group. We will also measure any side effects, pain experienced by patients in each group and ease of using each technique as well as explore barriers to using transcutaneous monitoring and identify any drawbacks of this method.REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
22/YH/0259
Date of REC Opinion
21 Nov 2022
REC opinion
Favourable Opinion