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BMC Pulmonary Medicine

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Open Access 01-12-2024 | Cough | Research

Investigating the risk of reintubation by cough force assessment using cough peak expiratory flow: a single-center observational pilot study

Authors: Kenya Murata, Keiichiro Shimoyama, Takeshi Tsuruya

Published in: BMC Pulmonary Medicine | Issue 1/2024

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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Title: Investigating the risk of reintubation by cough force assessment using cough peak expiratory flow: a single-center observational pilot study
Authors: Kenya Murata
Keiichiro Shimoyama
Takeshi Tsuruya
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Cough
Cough
Cough
Published in: BMC Pulmonary Medicine / Issue 1/2024
Electronic ISSN: 1471-2466
DOI: https://doi.org/10.1186/s12890-024-02914-0

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