| Interest of an objective evaluation of cough during weaning from mechanical ventilation. | |
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MedLine Citation:
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PMID: 19169666 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: This study aimed to evaluate an objective measure of cough strength, the peak cough expiratory flow (PCEF), as a predictive criterion of success or failure of extubation. METHODS: Patients under mechanical ventilation for more than 24 h who successfully passed the spontaneous breathing trial were included in the study. Just before extubation, PCEF was measured with an electronic flowmeter. RESULTS: A total of 130 patients were included. The median duration of mechanical ventilation before extubation was 8 days (4-17). Fourteen patients (10.8%) failed extubation. The sole factor significantly associated with extubation failure was the measure of PCEF. The patients who did not cough at order had a higher rate of extubation failure than those who did (P = 0.03). The mean PCEF of patients who failed extubation (36.3 +/- 15 l/min) was significantly lower than the one of patients who succeeded (63.6 +/- 32 l/min) (P < 0.001). The optimal cut-off value of PCEF was 35 l/min. Overall, an inability to cough at order or a PCEF < or =35 l/min predicted extubation failure with a sensitivity of 79% and a specificity of 71%. The risk of extubation failure was 24% for the patients who did not cough at order or with a PCEF < or =35 l/min and 3.5% for those with a PCEF >35 l/min [RR = 6.9 (95% CI, 2-24); P = 0.002]. CONCLUSIONS: This study confirmed the interest of measuring the PCEF to predict extubation outcome in patients having successfully passed the spontaneous breathing trial. |
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Authors:
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Pascal Beuret; Christophe Roux; Annie Auclair; Karim Nourdine; Mahmoud Kaaki; Marie-Jose Carton |
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Publication Detail:
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Type: Journal Article Date: 2009-01-24 |
Journal Detail:
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Title: Intensive care medicine Volume: 35 ISSN: 1432-1238 ISO Abbreviation: Intensive Care Med Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-05-26 Completed Date: 2009-09-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1090-3 Citation Subset: IM |
Affiliation:
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Intensive Care Unit, Centre Hospitalier Roanne, 28 rue de Charlieu, 42328 Roanne, France. pascal.beuret@ch-roanne.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cough* Female Forced Expiratory Flow Rates / physiology France Humans Male Middle Aged Outcome Assessment (Health Care) Predictive Value of Tests Ventilator Weaning / standards* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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