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Citric acid inhalation cough challenge: Establishing normative data

One of the most elusive challenges in the diagnosis and treatment of dysphagia is the
reliable identification of silent aspiration (aspiration in the absence of cough). The citric acid
inhalation cough challenge offers potential for aiding in identification of silent aspiration;
however clinical application of this technique is currently problematic due to an absence of
normative data. Therefore, this study aimed to establish a normative data set for the Citric-
Acid Inhalation Cough Challenge, as administered with facemask method. 80 healthy
subjects will participate in this study, constituting 2 age groups: above and below 60 years,
with equal gender representation. On 3 separate trials, they will be asked to passively inhale,
via a facemask, nebulised citric acid of concentrations ranging from 08M to 2.6M with
placebo interspersed. ‘Natural cough thresholds’ (NCT) and ‘Suppressed Cough Thresholds’
(SCT) will be reached when subjects cough on at least 2 out of 3 trials. The majority (92.5%)
of participants reached Natural Cough Threshold by 0.8M, with 68% demonstrating
Suppressed Cough Threshold also at this concentration. There were no significant
differences found between males and females (p<0.05) for either NCT (p=0.9885) or SCT
(p=0.44). Whilst no difference was found between youngers and elders for NCT (p=0.7254),
there was a significant difference for SCT (p=0.018), with youngers better able to suppress
cough. Over 90% of healthy people were found to elicit cough at 0.8M, inferring that this
level would be an adequate guide for use by clinicians testing for presence/absence of cough.

Identiferoai:union.ndltd.org:canterbury.ac.nz/oai:ir.canterbury.ac.nz:10092/4149
Date January 2010
CreatorsMonroe, Margaret Delia
PublisherUniversity of Canterbury. Communication Disorders
Source SetsUniversity of Canterbury
LanguageEnglish
Detected LanguageEnglish
TypeElectronic thesis or dissertation, Text
RightsCopyright Margaret Delia Monroe, http://library.canterbury.ac.nz/thesis/etheses_copyright.shtml
RelationNZCU

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