The Cough Reflex Intensity Score in Critically Ill Patients’ Airway Management: Study Protocol for a Multicenter, Prospective, Observational Trial

Background: A patient’s ability to cough is important for assessing a patient’s airway condition and likely mechanical ventilation outcome,there is still a lack of data comparing patients’ initial cough ability and outcomes. Methods The study is a prospective, observational trial which includes 144 patients from Xinjiang Medical University. After a patients is assigned a cough strength score, the cough intensity assessments will be implemented every other day for a week. The primary endpoint is whether the patient requires endotracheal intubation (including tracheostomy). Secondary endpoints include time spent under mechanical ventilation (excluding noninvasive ventilation), ICU and hospital lengths of stay, hospital expenses and in-hospital 30-day mortality. Discussion Anecdotally in our practice, we found that patients with a high Cough Reflex Intensity Score don't require endotracheal intubation, while patients with a low score always need to be intubated. This trial will test to what degree cough intensity is correlated to patient’s outcomes. Trial registration: Chinese Clinical Trial Registry,ChiCTR1900028265. Registered 16 December 2019