Evaluation between Cough Peak Flow and Cough Strength Score for Anticipating Reintubation after Scheduled Extubation

Introduction: Cough peak flow and cough strength score were used to anticipate extubation results inpatients where extubation was scheduled.Methods: Our prospective, randomized and double-blind investigation included 204 patients who werecandidates for extubation after a successful spontaneous breathing test in the intensive care unit of KingHussein medical center, Amman, Jordan, during the period Feb 2014-Apr2016. Cough strength score(CSS, graded 0-5) and cough peak flow (CPF) were evaluated before extubation. Reintubation wasrecorded 3 days after extubation.Findings: Reintubation incidence was 12.7 %( 26) during 3 days after scheduled extubation. Patientswith successful extubation had more cough strength scores than did reintubated patients (mean +/-SD,2.8 +/-1.4, 1.7 +/-1.3, respectively, P < 0.05) and cough peak flow (69.2 +/-31.4, 45.4 +/-19.9 L/min,respectively, P < 0.05). The cough strength score demonstrated a positive association with cough peakflow (P <0.05). Mean cough peak flows were 33.1 L/min, 34.4 L/min, 39.2 L/min, 52.6 L/min, 71.9L/min, and 106.8 L/min in patients with cough strength scores of 0, 1, 2, 3, 4, and 5, respectively. Whilecough strength score increased from 0 to 1 to 2 to 3 to 4 to 5, the reintubation incidence reduced from26.96%(55) to 22.5%(46) to 16.7%(34) to 13.7%(28) to 10.8%(22) to 1.96%(4).Conclusion: Cough strength score was suitable to record at the bedside in our intensive care unit. Coughstrength score was positively associated with cough peak flow and had the same result for anticipatingreintubation after scheduled extubation.

Keywords:

Cough peak flow , cough strength , reintubation , extubation