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Investigating the risk of reintubation by cough force assessment using cough peak expiratory flow: a single-center observational pilot study.
Murata, Kenya; Shimoyama, Keiichiro; Tsuruya, Takeshi.
Afiliación
  • Murata K; Department of Nursing, Tokyo Medical University Hospital, Tokyo, Japan. jpradish920@gmail.com.
  • Shimoyama K; Department of Emergency and Critical Care Medicine, Tokyo Medical University Hospital, Tokyo, Japan.
  • Tsuruya T; Department of Nursing, Tokyo Medical University Hospital, Tokyo, Japan.
BMC Pulm Med ; 24(1): 222, 2024 May 07.
Article en En | MEDLINE | ID: mdl-38714988
ABSTRACT

BACKGROUND:

No objective indicator exists for evaluating cough strength during extubation of tracheally intubated patients. This study aimed to determine whether cough peak expiratory flow (CPEF) can predict the risk of reintubation due to decreased cough strength.

METHODS:

This was a retrospective cohort study of patients who were admitted to our Emergency Intensive Care Unit between September 1, 2020 and August 31, 2021 and were under artificial ventilation management for ≥ 24 h. The patients were divided into two groups successful extubation and reintubation groups, and the relationship between CPEF immediately before extubation and reintubation was investigated.

RESULTS:

Seventy-six patients were analyzed. In the univariate analysis, CPEF was significantly different between the successful extubation (90.7 ± 25.9 L/min) and reintubation (57.2 ± 6.4 L/min) groups (p < 0.001). In the multivariate analysis with age and duration of artificial ventilation as covariates, CPEF was significantly lower in the reintubation group (p < 0.01). The cutoff value of CPEF for reintubation according to the receiver operating characteristic curve was 60 L/min (area under the curve, 0.897; sensitivity, 78.5%; specificity, 90.9%; p < 0.01).

CONCLUSION:

CPEF in tracheally intubated patients may be a useful indicator for predicting the risk of reintubation associated with decreased cough strength. The cutoff CPEF value for reintubation due to decreased cough strength was 60 L/min.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tos / Extubación Traqueal / Intubación Intratraqueal Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Pulm Med Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tos / Extubación Traqueal / Intubación Intratraqueal Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Pulm Med Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido