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However, there is no evidence that the arterial catheter could improve patient\u2019s outcome, whereas the burden of morbidity generated is significant (pain, thrombosis, infections). We hypothesise that patients with shock may be managed without an arterial catheter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The EVERDAC study is an investigator-initiated, pragmatic, multicentre, randomised, controlled, open-label, non-inferiority clinical trial, comparing a less invasive intervention (ie, no arterial catheter insertion until felt absolutely needed, according to predefined safety criteria) or usual care (ie, systematic arterial catheter insertion in the early hours of shock). 1010 patients will be randomised with a 1:1 ratio in two groups according to the strategy. The primary outcome is all-cause mortality by 28 days after inclusion. A health economic analysis will be carried out.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study has been approved by the Ethics Committee (Comit\u00e9 de Protection des Personnes \u00cele de France V, registration number 61606 CAT 2, 19 july 2018) and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03680963\">NCT03680963<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-044719","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T13:05:15Z","timestamp":1631624715000},"page":"e044719","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Early ve\n                    <b>r<\/b>\n                    sus differed arterial catheterisation in critically ill patients with acute circulatory failure: a multicentre, open-label, pragmatic, randomised, non-inferiority controlled trial: the EVERDAC protocol"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct03680963","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9284-3560","authenticated-orcid":false,"given":"Gr\u00e9goire","family":"Muller","sequence":"first","affiliation":[{"name":"Medical Intensive Care Unit, Centre Hospitalier R\u00e9gional d\"Orl\u00e9ans, Orl\u00e9ans, France"},{"name":"CRICS-TriggerSEP F-CRIN research network, Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toufik","family":"Kamel","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, Centre Hospitalier R\u00e9gional d\"Orl\u00e9ans, Orl\u00e9ans, France"},{"name":"CRICS-TriggerSEP F-CRIN research network, Tours, 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