COUGH-ICU: Correlation of Two Methods for Cough Peak Flow Measurement in Intubated Patients
Study Details
Study Description
Brief Summary
Cough Peak Flow (CPF) seems to be an efficient tool to assess cough capacity for the intensive care unit (ICU) ventilated patient. CPF can be used in the ventilator weaning process, as reflecting the upper airways protection capacity.
CPF requires disconnection of the patient from the ICU ventilator, supplemental material (handheld spirometer, antibacterial filter) and an excellent synchronization between the specialized caregiver and the patient.
We aimed that CPF with the ventilator built-in flow-meter is correlated with CPF using a handheld flowmeter connected to the endotracheal tube.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| cough peak flow measurement All enrolled patients will undergo measurement of cough peak flow by two methods, i.e. using a handheld electronic spirometer, and using the ventilator flowmeter, in a randomized order. |
Outcome Measures
Primary Outcome Measures
- Correlation coefficient for the two CPF assessment methods, on extubation day [Within 1 hour before mechanical ventilation termination (extubation)]
Correlation coefficient for the two CPF assessment methods, on extubation day
Secondary Outcome Measures
- Discriminatory power of CPF to predict successful weaning of mechanical ventilation, i.e. no reintubation within 72 hours after extubation, or unsuccessful weaning. [During the mechanical ventilation until 72 hours post extubation]
Thresholds of CPF will be tested as predictors of weaning success
- Assess the correlation between CPF and length of mechanical ventilation [During the mechanical ventilation until 72 hours post extubation]
Assess the correlation between CPF and length of mechanical ventilation
- 3. Correlation between the two CPF assessment methods the days before extubation [During the mechanical ventilation until 72 hours post extubation]
3. Correlation between the two CPF assessment methods the days before extubation
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age > 18 years
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Mechanically ventilated patient > 24 hours
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Weaning ventilator phase (PEEP < 9 cmH2O and Support < 15 cm H2O)
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Richmond Agitation Sedation Scale between -1 and +1
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Patient's agreement to participate
Exclusion Criteria:
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Pregnant women
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Bronchospasm
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FiO2 > 70%
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Thoracic surgery < 7 days
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Abdominal surgery < 7 days
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Thoracic injury with rib fracture < 21 days
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Pneumothorax < 24 hours
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | CHR d'Orléans | Orléans | France | 45000 |
Sponsors and Collaborators
- Centre Hospitalier Régional d'Orléans
Investigators
- Principal Investigator: Guillaume FOSSAT, CHR Orléans
Study Documents (Full-Text)
None provided.More Information
Publications
- Macintyre NR. Evidence-based assessments in the ventilator discontinuation process. Respir Care. 2012 Oct;57(10):1611-8. Review.
- Smina M, Salam A, Khamiees M, Gada P, Amoateng-Adjepong Y, Manthous CA. Cough peak flows and extubation outcomes. Chest. 2003 Jul;124(1):262-8.
- Su WL, Chen YH, Chen CW, Yang SH, Su CL, Perng WC, Wu CP, Chen JH. Involuntary cough strength and extubation outcomes for patients in an ICU. Chest. 2010 Apr;137(4):777-82. doi: 10.1378/chest.07-2808. Epub 2010 Jan 22.
- Thille AW, Richard JC, Brochard L. The decision to extubate in the intensive care unit. Am J Respir Crit Care Med. 2013 Jun 15;187(12):1294-302. doi: 10.1164/rccm.201208-1523CI. Review.
- CHRO-2017-02