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"Death Rattle" - A Double Blind, Randomly Controlled, Crossover Trial

This study has been terminated.
(Difficulties in recruiting appropriate participants to the study)
Ben-Gurion University of the Negev
Information provided by (Responsible Party):
Pesach Shvartzman, Soroka University Medical Center Identifier:
First received: May 1, 2006
Last updated: July 3, 2012
Last verified: July 2012

Dying patients are often unable to clear secretions from their large airways, resulting in noisy breathing usually described as "death rattle." While there is no evidence that patients find this condition disturbing, the noises may be disturbing to the patient's visitors and caregivers who may fear that the patient is choking to death.

In Israel none of the pharmaceutical drugs listed in the literature exist. Thus, Atropine drops which have been noted in the literature as being used, though according to our knowledge no evidence of clinical trials using sublingual Atropine were conducted.

The study is designed as a randomly controlled, double blind crossover trial. The patient will serve as control for himself, as crossover between placebo and drug (randomly chosen) will take place. The administrator of the drug will be blinded to the medication, each time randomly beginning with a different drug (placebo or Atropine).

We will evaluate Atropine Sulphate 1% ophthalmic drops effect on 33 patients using a noise score scale of 0-3. Noise scores will be taken at the start; 30 min after drug/placebo administration and every hour thereafter. After 4-hours crossover will take place and evaluation will follow the same protocol.

Condition Intervention
Drug: Atropine Sulphate 1% ophthalmic drops

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double Blind (Participant, Care Provider)
Primary Purpose: Treatment
Official Title: "Death Rattle" - A Double Blind, Randomly Controlled, Crossover Trial

Resource links provided by NLM:

Further study details as provided by Soroka University Medical Center:

Primary Outcome Measures:
  • Noise Level [ Time Frame: 8 hours ]
    30 min after drug administration; and hourly after the initial administration. if needed a repeat dose will be given and the noise score will be evaluated at 30 min; and hourly thereafter. The repeat dose will be left to the nurses' discretion if they thought the rattle to be unacceptable.

Enrollment: 2
Study Start Date: January 2007
Study Completion Date: June 2012
Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: Atropine Sulphate 1% ophthalmic drops
    Atropine Sulphate 1% ophthalmic drops will be used, by Fisher Pharmaceutical Labs, at a dose of 2 drops per administration

Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • : Patients belonging to Home Palliative Care Unit of Clalit Health Services - Southern District, and the Oncology Department of Soroka University Medical Center and suffering from "death rattle" will be recruited for the study.

Exclusion Criteria:

  Contacts and Locations
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Please refer to this study by its identifier: NCT00320892

Ben-Gurion University of the Negev, Sial Research Center for Family Medicine and Primary Care
Beer-Sheva, Israel, 653
Sponsors and Collaborators
Soroka University Medical Center
Ben-Gurion University of the Negev
Study Chair: Pesach Shvartzman Ben-Gurion University of the Negev
  More Information

Responsible Party: Pesach Shvartzman, Head Family Medicine Department, Soroka University Medical Center Identifier: NCT00320892     History of Changes
Other Study ID Numbers: SOR416506CTIL
Study First Received: May 1, 2006
Last Updated: July 3, 2012

Keywords provided by Soroka University Medical Center:
Death Rattle
Noise level
Primary Care

Additional relevant MeSH terms:
Pathologic Processes
Ophthalmic Solutions
Pharmaceutical Solutions
Adjuvants, Anesthesia
Anti-Arrhythmia Agents
Bronchodilator Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Asthmatic Agents
Respiratory System Agents
Muscarinic Antagonists
Cholinergic Antagonists
Cholinergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action processed this record on May 22, 2017