Involuntary cough strength and extubation outcomes for patients in an ICU

Wen Lin Su, Yeong Hwang Chen, Chien Wen Chen, Shih Hsing Yang, Chien Ling Su, Wann Cherng Perng, Chin Pyng Wu, Jenn Han Chen

Research output: Contribution to journalArticlepeer-review

81 Citations (Scopus)

Abstract

Background: Removing the artificial airway is the lasl slep in the mechanical ventilation withdrawal process. In order Io assess cough effectiveness, a critical component of this process, we evaluated the involuntary cough peak flow (CPFi) to predict the exlubalion outcome for palienls weaned from mechanical ventilation in ICUs. Methods: One hundred fifty patients were weaned from ventilators, passed a spontaneous breathing trial (SBT), and were judged by their physician to be ready for extubation in the Tri-Serviee General Hospital ICUs from February 2003'to July 2003. CPFi was induced by 2 mL of normal saline solution at the end of inspiration and measured using a hand-held respiratory mechanics monitor. All patients were then extubated. Results: Of 150 enrolled patients for this study, 118 (78.7%) bad successful extubation and 32 (21.3%) failed. In the univariate analysis, there were higher Acule Physiology and Chronic Health Evaluation (APACHE) II scores (16.0 vs 18.5, F = .018), less negative maximum inspiratory pressure (-45.0 vs -39.0, F =.010), lower cough peak flows (CPFs) (74.0 vs 42.0 Iimin, P<.001), longer poslexlubalion hospital slays (15.0 vs 31.5 days, F<.001), and longer poslexlubalion ICU slays (1.0 vs 9.5 days, F

Original languageEnglish
Pages (from-to)777-782
Number of pages6
JournalChest
Volume137
Issue number4
DOIs
Publication statusPublished - Apr 1 2010

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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