Heel Warming Before Capillary Blood Sampling

NCT ID: NCT04995393

Last Updated: 2021-08-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

176 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-26

Study Completion Date

2021-02-12

Brief Summary

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Capillary blood sampling from the heel is often used in the treatment of infants admitted to neonatal intensive care (NICU). In Danish NICUs a heated blanket, a heated gel pad or a disposable glove with warm water are the methods most often used.

The purpose of this randomized controlled study is to investigate which of the mentioned heating methods ensures the best quality of the blood sample and provides the most gentle blood sampling for the infant.

Detailed Description

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Some infants experience a difficult and painful blood sampling which can lead to bruised or swollen heels and a blood sample of poor quality. To minimize the risk of that, the infant's heel is heated before the procedure as described in standard GP42-A6 from The Clinical and Laboratory Standards Institute. However, no consensus exists on which heating method to use. The aim of this study is to compare three different heating methods in terms of which method can help reduce pain experienced by infants as well as increase the quality of the blood samples.

Infants (postmenstrual age ≥ 28 + 0) admitted to the NICU, Kolding Hospital and having a blood sample taken by a Biomedical Laboratory Scientist are invited to participate. A parental informed concent must be signed by both parents before participation.

Infants are randomized to one of the three heating methods: glove, blanket or gel pad.

The following blood sampling procedure is closely monitored to register data corresponding to the five outcome measures.

Furthermore the infants personal data, location of the infant during the procedure, surface temperature of the heel before and after heating, volume of sampled blood, sign of bruises and swelling as well as hematocrit are registered.

Data registration, web-based block randomization, data storage and statistical analysis are supported by OPEN (Open Patient data Explorative Network, University of Southern Denmark).

The study is registered as public research at the Region of Southern Denmark (journal no. 20/1316) and is approved by The Regional Committees on Health Research Ethics for Southern Denmark (ID S-20200082).

Conditions

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Blood Specimen Collection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors
Also masked: Biomedical Laboratory Scientist

Study Groups

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Glove

A heated glove containing water.

Group Type ACTIVE_COMPARATOR

Heating with a disposable glove containing water

Intervention Type PROCEDURE

Heating of the infants heel with a glove before blood sampling.

Blanket

A heated blanket.

Group Type ACTIVE_COMPARATOR

Heating with a blanket

Intervention Type PROCEDURE

Heating of the infants heel with a blanket before blood sampling.

Gel pack

A heated gel pack.

Group Type ACTIVE_COMPARATOR

Heating with a gel pack

Intervention Type PROCEDURE

Heating of the infants heel with a gel pack before blood sampling.

Interventions

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Heating with a disposable glove containing water

Heating of the infants heel with a glove before blood sampling.

Intervention Type PROCEDURE

Heating with a blanket

Heating of the infants heel with a blanket before blood sampling.

Intervention Type PROCEDURE

Heating with a gel pack

Heating of the infants heel with a gel pack before blood sampling.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* PMA (postmenstrual age) ≥ 28+0
* Blood sampling performed by a Biomedical Laboratory Scientist

Exclusion Criteria

* GA (gestational age) ≥ 44+0
* Weight \> 6000 g
* Coagulation related disorder
* Severe illness/disorder
* Heel is bruised or swollen
* Parents not understanding written Danish language
Minimum Eligible Age

2 Hours

Maximum Eligible Age

77 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Region of Southern Denmark

OTHER

Sponsor Role collaborator

Development and Innovation Fund at Lillebaelt Hospital

UNKNOWN

Sponsor Role collaborator

The Research Council for Sygehus Lillebælt

UNKNOWN

Sponsor Role collaborator

Sygekassernes Helsefond

OTHER

Sponsor Role collaborator

The Biomedical Laboratory Scientist Education and Research Fund

UNKNOWN

Sponsor Role collaborator

Kolding Sygehus

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jonna Skov Madsen

Role: STUDY_DIRECTOR

Clinical Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark

Patricia Diana Soerensen

Role: STUDY_CHAIR

Clinical Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark

Ulla List Toennesen

Role: PRINCIPAL_INVESTIGATOR

Clinical Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark

Locations

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Neonatal intensive care (NICU), Lillebaelt Hospital, University Hospital of Southern Denmark

Kolding, Region Southern Denmark, Denmark

Site Status

Countries

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Denmark

References

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Valeri BO, Holsti L, Linhares MB. Neonatal pain and developmental outcomes in children born preterm: a systematic review. Clin J Pain. 2015 Apr;31(4):355-62. doi: 10.1097/AJP.0000000000000114.

Reference Type BACKGROUND
PMID: 24866853 (View on PubMed)

Anand KJ; International Evidence-Based Group for Neonatal Pain. Consensus statement for the prevention and management of pain in the newborn. Arch Pediatr Adolesc Med. 2001 Feb;155(2):173-80. doi: 10.1001/archpedi.155.2.173.

Reference Type BACKGROUND
PMID: 11177093 (View on PubMed)

Losacco V, Cuttini M, Greisen G, Haumont D, Pallas-Alonso CR, Pierrat V, Warren I, Smit BJ, Westrup B, Sizun J; ESF Network. Heel blood sampling in European neonatal intensive care units: compliance with pain management guidelines. Arch Dis Child Fetal Neonatal Ed. 2011 Jan;96(1):F65-8. doi: 10.1136/adc.2010.186429.

Reference Type BACKGROUND
PMID: 21177753 (View on PubMed)

Janes M, Pinelli J, Landry S, Downey S, Paes B. Comparison of capillary blood sampling using an automated incision device with and without warming the heel. J Perinatol. 2002 Mar;22(2):154-8. doi: 10.1038/sj.jp.7210583.

Reference Type BACKGROUND
PMID: 11896522 (View on PubMed)

Aydin D, Inal S. Effects of breastfeeding and heel warming on pain levels during heel stick in neonates. Int J Nurs Pract. 2019 Jun;25(3):e12734. doi: 10.1111/ijn.12734. Epub 2019 Apr 17.

Reference Type BACKGROUND
PMID: 30993840 (View on PubMed)

WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy. Geneva: World Health Organization; 2010. Available from http://www.ncbi.nlm.nih.gov/books/NBK138650/

Reference Type BACKGROUND
PMID: 23741774 (View on PubMed)

Hassan Z, Shah M. Scald injury from the Guthrie test: should the heel be warmed? Arch Dis Child Fetal Neonatal Ed. 2005 Nov;90(6):F533-4. doi: 10.1136/adc.2005.072678.

Reference Type BACKGROUND
PMID: 16244215 (View on PubMed)

Shu SH, Lee YL, Hayter M, Wang RH. Efficacy of swaddling and heel warming on pain response to heel stick in neonates: a randomised control trial. J Clin Nurs. 2014 Nov;23(21-22):3107-14. doi: 10.1111/jocn.12549. Epub 2014 Jan 30.

Reference Type BACKGROUND
PMID: 24476226 (View on PubMed)

Folk LA. Guide to capillary heelstick blood sampling in infants. Adv Neonatal Care. 2007 Aug;7(4):171-8. doi: 10.1097/01.ANC.0000286333.67928.04.

Reference Type BACKGROUND
PMID: 17700190 (View on PubMed)

Sorrentino G, Fumagalli M, Milani S, Cortinovis I, Zorz A, Cavallaro G, Mosca F, Plevani L. The impact of automatic devices for capillary blood collection on efficiency and pain response in newborns: A randomized controlled trial. Int J Nurs Stud. 2017 Jul;72:24-29. doi: 10.1016/j.ijnurstu.2017.04.001. Epub 2017 Apr 11.

Reference Type BACKGROUND
PMID: 28431226 (View on PubMed)

Other Identifiers

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S-20200082

Identifier Type: -

Identifier Source: org_study_id

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