Clinical trial NCT04051541: Simulation of Adenosine Push Methods for Treatment of SVT Using Agitated Saline Visualized by Ultrasound
Official title: Simulation of Adenosine Push Methods for Treatment of SVT Using Agitated Saline Visualized by Ultrasound
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Supraventricular Tachycardia
Lead sponsor: HealthPartners Institute
Sponsor class: OTHER
First posted: 2019-08-09
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: This is a simulation study in which all participants receive a dose of agitated saline through an IV using three different administration methods.
Primary purpose: OTHER

Brief summary: Supraventricular tachycardia (SVT) is an abnormally fast heart rhythm arising from improper electrical activity in the upper part of the heart. SVT is commonly treated with adenosine using three different IV administration techniques. However, it is not well known which of these three techniques is the quickest or most likely to reach the heart in order to stop SVT. This study will simulate each of those techniques in an investigator-blinded procedure. Intravenous agitated saline, used as a surrogate for a dose of adenosine, will be administered to healthy volunteers using all three techniques and monitored using bedside ultrasound to observe their efficacy and speed in reaching the right side of the heart.


Eligibility criteria: Inclusion Criteria:

* Volunteers aged 18 years and older
* Able to understand and provide signed consent for the study
* Must be healthy; not being actively treated for any condition that requires active medical intervention or monitoring to avert serious danger to the participant's health or well-being, as evaluated by study investigator

Exclusion Criteria:

* Non-English speaker
* Those with contraindications to peripheral IV placement, such as infection or other contraindication noted from evaluation by study investigator
* Pregnancy

Primary outcomes:
measure: Time to ultrasound visualization of agitated saline in the right heart
timeFrame: <5 seconds
Secondary outcomes:
Other outcomes:
Locations:
city: Saint Paul
country: United States
facility: Regions Hospital
state: Minnesota
Study officials:
References:
citation: Murman DH, McDonald AJ, Pelletier AJ, Camargo CA Jr. U.S. emergency department visits for supraventricular tachycardia, 1993-2003. Acad Emerg Med. 2007 Jun;14(6):578-81. doi: 10.1197/j.aem.2007.01.013. Epub 2007 Apr 20.
citation: Brubaker S, Long B, Koyfman A. Alternative Treatment Options for Atrioventricular-Nodal-Reentry Tachycardia: An Emergency Medicine Review. J Emerg Med. 2018 Feb;54(2):198-206. doi: 10.1016/j.jemermed.2017.10.003. Epub 2017 Nov 26.
citation: Alabed S, Sabouni A, Providencia R, Atallah E, Qintar M, Chico TJ. Adenosine versus intravenous calcium channel antagonists for supraventricular tachycardia. Cochrane Database Syst Rev. 2017 Oct 12;10(10):CD005154. doi: 10.1002/14651858.CD005154.pub4.
citation: Weberding NT, Saladino RA, Minnigh MB, Oberly PJ, Tudorascu DL, Poloyac SM, Manole MD. Adenosine Administration With a Stopcock Technique Delivers Lower-Than-Intended Drug Doses. Ann Emerg Med. 2018 Feb;71(2):220-224. doi: 10.1016/j.annemergmed.2017.09.002. Epub 2017 Oct 28.
citation: Losek JD, Endom E, Dietrich A, Stewart G, Zempsky W, Smith K. Adenosine and pediatric supraventricular tachycardia in the emergency department: multicenter study and review. Ann Emerg Med. 1999 Feb;33(2):185-91. doi: 10.1016/s0196-0644(99)70392-6.
citation: Kleinman ME, Chameides L, Schexnayder SM, Samson RA, Hazinski MF, Atkins DL, Berg MD, de Caen AR, Fink EL, Freid EB, Hickey RW, Marino BS, Nadkarni VM, Proctor LT, Qureshi FA, Sartorelli K, Topjian A, van der Jagt EW, Zaritsky AL. Part 14: pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S876-908. doi: 10.1161/CIRCULATIONAHA.110.971101. No abstract available.
citation: Madsen CD, Pointer JE, Lynch TG. A comparison of adenosine and verapamil for the treatment of supraventricular tachycardia in the prehospital setting. Ann Emerg Med. 1995 May;25(5):649-55. doi: 10.1016/s0196-0644(95)70179-6.
citation: Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, Kudenchuk PJ, Ornato JP, McNally B, Silvers SM, Passman RS, White RD, Hess EP, Tang W, Davis D, Sinz E, Morrison LJ. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S729-67. doi: 10.1161/CIRCULATIONAHA.110.970988.
citation: Ng GA, Martin W, Rankin AC. Imaging of adenosine bolus transit following intravenous administration: insights into antiarrhythmic efficacy. Heart. 1999 Aug;82(2):163-9. doi: 10.1136/hrt.82.2.163.
citation: Wen M, Stock K, Heemann U, Aussieker M, Kuchle C. Agitated saline bubble-enhanced transthoracic echocardiography: a novel method to visualize the position of central venous catheter. Crit Care Med. 2014 Mar;42(3):e231-3. doi: 10.1097/CCM.0000000000000130.
citation: Duran-Gehring PE, Guirgis FW, McKee KC, Goggans S, Tran H, Kalynych CJ, Wears RL. The bubble study: ultrasound confirmation of central venous catheter placement. Am J Emerg Med. 2015 Mar;33(3):315-9. doi: 10.1016/j.ajem.2014.10.010. Epub 2014 Oct 13.
citation: Gekle R, Dubensky L, Haddad S, Bramante R, Cirilli A, Catlin T, Patel G, D'Amore J, Slesinger TL, Raio C, Modayil V, Nelson M. Saline Flush Test: Can Bedside Sonography Replace Conventional Radiography for Confirmation of Above-the-Diaphragm Central Venous Catheter Placement? J Ultrasound Med. 2015 Jul;34(7):1295-9. doi: 10.7863/ultra.34.7.1295.
citation: Weekes AJ, Johnson DA, Keller SM, Efune B, Carey C, Rozario NL, Norton HJ. Central vascular catheter placement evaluation using saline flush and bedside echocardiography. Acad Emerg Med. 2014 Jan;21(1):65-72. doi: 10.1111/acem.12283.
citation: Ketkar VA, Kolling WM, Nardviriyakul N, VanDer Kamp K, Wurster DE. Stability of undiluted and diluted adenosine at three temperatures in syringes and bags. Am J Health Syst Pharm. 1998 Mar 1;55(5):466-70. doi: 10.1093/ajhp/55.5.466.
citation: Green AP, Giattina KH. Adenosine administration for neonatal SVT. Neonatal Netw. 1993 Aug;12(5):15-8.