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Trial registered on ANZCTR
Registration number
ACTRN12614000917639
Ethics application status
Approved
Date submitted
30/07/2014
Date registered
27/08/2014
Date last updated
27/08/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
Cough Reflex after Intubation (CRAIn)
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Scientific title
Recovery of Cough Following Extubation after Coronary Artery Bypass Grafting: A Prospective Study.
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Secondary ID [1]
285081
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Nil
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Universal Trial Number (UTN)
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Trial acronym
CRAIn
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Intubation
292610
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Dysphagia
292611
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Coronary Artery Bypass Grafting
292612
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Condition category
Condition code
Surgery
292926
292926
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0
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Other surgery
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Cardiovascular
293103
293103
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0
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Coronary heart disease
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Participants underwent cough reflex testing (CRT) before intubation and after extubation for coronary artery bypass grafting. This study was observational.
CRT is performed by asking the participant to inhale nebulised citric acid. The citric acid is presented via face mask. The participant is instructed to "try not to cough". If the participant produced a cough on 2 out of 3 trials their cough was considered present. Three concentrations of citric acid, 0.4, 0.8 and 1.2 mol/L, were interspersed with normal saline trials to establish each participant's baseline.
Baseline CRT was performed before surgery and follow-up CRT was performed within two hours of extubation and then every morning and evening until the participant had a present cough at baseline level, withdrew or was discharged from hospital.
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Intervention code [1]
289920
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Not applicable
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Comparator / control treatment
N/A
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Return of reflexive cough as measured by a cough present at baseline CRT level.
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Assessment method [1]
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Timepoint [1]
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Within two hours after extubation and approximately every 12 hours after until cough returned
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Secondary outcome [1]
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Nil
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Assessment method [1]
309690
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Timepoint [1]
309690
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Nil
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Eligibility
Key inclusion criteria
Adults undergoing coronary artery bypass grafting
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients having valve replacement, history of dysphagia, head and neck cancer or neurological condition, abnormal cough reflex at baseline
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
The study population is patients undergoing elective cardiothoracic surgery at Wellington Hospital. This is a single cohort observational study. With 100 participants the study will have 90% power to estimate the proportion of patients whose cough reflex has diminished with a measurement error of +/- 10% (Stata/IC 11.2, StataCorp LP, Texas, USA).
The average time post-extubation of each follow-up and the
percentage of participants with cough response present at baseline level at each follow-up will be calculated.Time to cough response present for each participant will be plotted using the Kaplan-Meier survival curve and log rank tests performed to evaluate for significance between groups with an a priori significance level set at .05.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
14/01/2013
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Actual
22/01/2013
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Date of last participant enrolment
Anticipated
3/06/2013
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Actual
8/09/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
6260
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New Zealand
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State/province [1]
6260
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Wellington
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Funding & Sponsors
Funding source category [1]
289686
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University
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Name [1]
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University of Canterbury
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Address [1]
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Department of Communication Disorders
University of Canterbury
Private Bag 4800
CHRISTCHURCH 8140
New Zealand
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Country [1]
289686
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New Zealand
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Primary sponsor type
University
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Name
University of Canterbury
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Address
Department of Communication Disorders
University of Canterbury
Private Bag 4800
CHRISTCHURCH 8140
New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
288381
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Hospital
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Name [1]
288381
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Capital & Coast District Health Board
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Address [1]
288381
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Private Bag 7902
Riddiford Street
Newtown
Wellington 6242
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Country [1]
288381
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Central Health and Disability Ethics Committee
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Ethics committee address [1]
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1 The Terrace PO Box 5013 Wellington 6011
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Ethics committee country [1]
291427
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New Zealand
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Date submitted for ethics approval [1]
291427
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Approval date [1]
291427
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10/12/2012
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Ethics approval number [1]
291427
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12/CEN/50
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Summary
Brief summary
Participants undergoing CABG had a baseline cough reflex test (CRT) before surgery/intubation. The CRT was repeated within two hours of extubation. Participants with no change for their baseline had no further testing as cough was considered unchanged. Participants with absent cough were retested every morning and evening until baseline cough returned or the participant withdrew, was discharged or died. The cough reflex is an important airway clearance mechanism that protects the airway from aspiration. The researchers wanted to determine how long patients' cough is absent after intubation and if any variables are predictive of recovery.
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Trial website
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Trial related presentations / publications
Kallesen, M., Psirides, A. & Huckabee, ML. (2014, March). A Prospective Study of Cough Response to Nebulised Citric Acid following Ventilation for Elective Cardiac Surgery. Poster presented at the annual meeting of the Dysphagia Research Society, Nashville, TN.
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Public notes
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Contacts
Principal investigator
Name
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Ms Molly Kallesen
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Address
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Level 10, Grace Neil Block
Wellington Hospital
Private Bag 7902
Wellington 6242
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Country
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New Zealand
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Phone
50318
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6448062345
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Molly Kallesen
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Address
50319
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Level 10, Grace Neil Block
Wellington Hospital
Private Bag 7902
Wellington 6242
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Country
50319
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New Zealand
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Phone
50319
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6448062345
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Fax
50319
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Email
50319
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[email protected]
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Contact person for scientific queries
Name
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Molly Kallesen
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Address
50320
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Level 10, Grace Neil Block
Wellington Hospital
Private Bag 7902
Wellington 6242
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Country
50320
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New Zealand
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Phone
50320
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6448062345
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Fax
50320
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Email
50320
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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