Preventing Pneumonia and Other Respiratory Problems in Persons With Spinal Cord Injury
14 de enero de 2013 actualizado por: Trevor Dyson-Hudson, M.D., Kessler Foundation
Prevention of Long-Term Respiratory Complications of Spinal Cord Injury: a Randomized Controlled Trial
It is known that individuals with spinal cord injury are at increased risk for respiratory tract infections like pneumonia. Part of this risk is due to weakened chest and abdominal muscles that are vital to deep breathing and the ability to cough. The purpose of this study is to look at the effectiveness of two different treatments in preventing pneumonia and other respiratory problems in persons with SCI.
This is a randomized controlled trial investigating the effectiveness of two different treatments. Participants will be randomly assigned to one of the two treatment groups. They will not be told the details of the other intervention since this could influence or change their activities during the study.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Intervencionista
Inscripción (Actual)
120
Fase
- Fase 2
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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New Jersey
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West Orange, New Jersey, Estados Unidos, 07052
- Kessler Institute for Rehabilitation
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años a 70 años (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Chronic spinal cord injury that occurred more than 6 months ago
- An impaired ability to cough (cough peak flow less than 300 L/min)
- Oxygen saturation greater than or equal to 95% when awake and not receiving supplemental oxygen
- End-tidal carbon dioxide level less than 43 mm Hg
- Without a fever or other signs of an acute illness for the previous 2 weeks
- Able to learn the treatment protocol and have someone available at home to assist if needed to help set-up and use the equipment
Exclusion Criteria:
- Under 18 years of age
- Currently have a tracheotomy tube
- Have a history of an acute illness in the last 2 weeks
- Have lung disease as seen on chest x-ray that results in a baseline oxygen saturation decreasing below 95% during daytime hours and cannot be normalized by usual way of coughing
- Already utilizing an oximetry protocol
- Have a significant medical complication and psychiatric condition that would interfere with the conduct of the study or interpretation of the study results.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Prevención
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Doble
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Experimental: Manual and mechanical assisted cough
Individuals will be given a pulse oximeter and taught both manually assisted and mechanically assisted coughing techniques to maximize their cough peak flow.
Manually assisted coughing consists of air stacking to deep insufflations.
An abdominal thrust is then applied upon glottic opening to augment the cough peak flow.
Subjects will also have rapid access to a mechanical in-exsufflator (CoughAssistTM) and will be trained on how to access and use this device.
Mechanically assisted coughing (MAC) involves the use of the CoughAssistTM to expand the lungs and then quickly reverse the pressure to rapidly empty the lungs with expiratory (cough) flows of 600 L/m.
An abdominal (manual) thrust is applied in conjunction with the negative pressure (exsufflation) to further increase cough.
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Individuals will be given a pulse oximeter and taught both manually assisted and mechanically assisted coughing techniques to maximize their cough.
Manually assisted coughing consists of air stacking to deep insufflations.
An abdominal thrust is then applied upon glottic opening to augment the cough.
These subjects will also have rapid access to a mechanical in-exsufflator (CoughAssistTM) and will be trained on how to access and use this device.
Mechanically assisted coughing (MAC) involves the use of the CoughAssistTM to expand the lungs and then quickly reverse the pressure to rapidly empty the lungs with expiratory (cough) flows of 600 L/m.
An abdominal (manual) thrust is applied in conjunction with the negative pressure (exsufflation) to further increase cough.
Otros nombres:
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Comparador activo: Incentive spirometry
The active control group will consist of individuals assigned to the oximetry with incentive spirometry group.
These individuals will be given a pulse oximeter and an incentive spirometer (AirLife Company) and taught how to use them.
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These individuals will be given a pulse oximeter and an incentive spirometer (AirLife Company) and taught how to use them.
Otros nombres:
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
|---|---|
|
Reductions in episodes of community acquired pneumonia (CAP) and related severe respiratory complications
Periodo de tiempo: 3 years
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3 years
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Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
|---|---|
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Reductions in hospitalizations due to a primary diagnosis of a respiratory complications
Periodo de tiempo: 3 years
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3 years
|
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Duration of illness and hospitalization
Periodo de tiempo: 3 years
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3 years
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Impact of respiratory complications on quality of life and participation
Periodo de tiempo: 3 years
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3 years
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Colaboradores
Investigadores
- Investigador principal: John Bach, M.D., University of Medicine and Dentistry - The New Jersey Medical School, Newark, N.J.
- Investigador principal: Steven Kirshblum, M.D., Kessler Institute for Rehabilitation, West Orange, N.J.
- Director de estudio: Trevor A. Dyson-Hudson, M.D., Kessler Foundation
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de junio de 2007
Finalización primaria (Actual)
1 de diciembre de 2012
Finalización del estudio (Actual)
1 de diciembre de 2012
Fechas de registro del estudio
Enviado por primera vez
13 de marzo de 2007
Primero enviado que cumplió con los criterios de control de calidad
13 de marzo de 2007
Publicado por primera vez (Estimar)
15 de marzo de 2007
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
15 de enero de 2013
Última actualización enviada que cumplió con los criterios de control de calidad
14 de enero de 2013
Última verificación
1 de enero de 2013
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- H133N060022
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