- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04496986
Dysphagia in Cardiac Surgical Patients_
Mechanisms, Predictors and Clinical Markers of Dysphagia in Cardiac Surgical Patients
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria: 1) individuals over 18 years of age, 2) undergoing a cardiovascular procedure at the University of Florida Heart and Vascular Hospital, 3) confirmed negative COVID-19 test result, 4) no allergies to barium, 5) not pregnant (female participants), and 6) willing to participate in research exams.
Exclusion Criteria: 1) individuals under the age of 18, 2) patients with a confirmed positive COVID-19 test result, 3) participants with allergies to barium, 4) pregnant women, or 5) unwilling to participate in research exams.
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Cardiovascular Surgical Patients Preoperative Exam
All enrolled participants will undergo a baseline Fiberoptic Endoscopic Evaluation of Swallowing (FEES) before their surgery to determine baseline / preoperative swallowing function.
Those with confirmed dysphagia will not be asked to complete the postoperative swallowing exam, given our desire to examine contributing risk factors for dysphagia development and mechanisms within cardiovascular surgical patients.
In addition to the instrumental exam, systematic collection of demographic, medical, surgical, and intubation-related candidate predictor variables will be conducted over the entire perioperative period.
|
This procedure involves inserting a flexible laryngoscope that contains a light source and video camera on the end through the open passage of the nose towards the back of the throat in order to visualize the swallowing mechanism.
Other Names:
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Cardiovascular Surgical Patients Postoperative Exam
All remaining participants without preoperative dysphagia will be seen for a postoperative exam performed within 48 hours of extubation.
Simultaneous imaging using FEES and videofluoroscopy will be performed at the bedside, as well as a battery of clinical tests.
Completion of these postoperative tests will indicate study completion for participants without evidence of dysphagia, while participants who demonstrate acute-phase postoperative dysphagia will continue to participate if they desire.
During their standard of care one-month follow-up appointment, a third research evaluation will be offered for participants with previously identified postoperative dysphagia.
During this exam, the same imaging and clinical tests from the previous research exam will be performed.
Finally, participants with persisting dysphagia will be offered the opportunity to continue to be studied for a fourth and final research exam during their standard of care six-month follow up clinic visit.
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This procedure involves inserting a flexible laryngoscope that contains a light source and video camera on the end through the open passage of the nose towards the back of the throat in order to visualize the swallowing mechanism.
Other Names:
Cough PEF will be performed to index a participant's physiologic airway defense capacity and strength.
Testing will occur with the participant seated upright at 90 degrees using an analog peak flow meter with a one-way expiratory valve that prevents a participant from breathing air in from the device to reduce contamination.
Participants will be seated upright and administered reflex cough testing via a disposable adult aerosol mask with an attached nebulizer that contains a solution to elicit a cough response.
Lingual strength will be evaluated using the Iowa Oral Pressure Instrument (IOPI).
Participants will be seated upright, and the SLP will place the IOPI air-filled sensing bulb in the midline anterior position on the participant's tongue, posterior to the alveolar ridge.
Speech assessment will occur with the participant comfortably seated headset microphone with a lapel windscreen connected to a TASCAM DR40 to allow for high-quality audio recordings.
Individuals will be asked to perform two maximal performance speech tasks that include vowel prolongation of /a/, and a Diadochokinetic (DDK) rate task to examine SMR for production of the word "buttercup."
This procedure involves inserting a flexible laryngoscope that contains a light source and video camera on the end through the open passage of the nose towards the back of the throat in order to visualize the swallowing mechanism.
The participant will be asked to perform some voicing tasks, once completed, a videofluoroscopic swallowing exam will occur at the same time.
This is like moving x-ray of the participant swallowing foods and liquids (barium).
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Penetration Aspiration Scale
Time Frame: Baseline (Prior to surgery)
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This scale is a validated measure used by trained blinded clinicians to assign ratings of safety to swallowing bolus trials.
The development and use of an 8-point, equal-appearing interval scale (8 being best; 1 being worst) to describe penetration and aspiration events are described.
Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled.
(FEES)
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Baseline (Prior to surgery)
|
Penetration Aspiration Scale
Time Frame: Follow-up - Within 72 hours following extubation from surgery and onward
|
This scale is a validated measure used by trained blinded clinicians to assign ratings of safety to swallowing bolus trials.
The development and use of an 8-point, equal-appearing interval scale (8 being best; 1 being worst) to describe penetration and aspiration events are described.
Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled.
(Used in both FEES and VFSS)
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Follow-up - Within 72 hours following extubation from surgery and onward
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Emily K Plowman, PhD, University of Florida
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB202001367
- OCR39324 (Other Identifier: OCR OnCore)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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