Weak cough strength associated with increased extubation failure, finds study
The predictive power of extubation failure diagnosed by cough strength varies by study. Researchers have conducted a meta-analysis to summarise the diagnostic power of extubation failure tested by cough strength.
Researchers have found that a weak cough is associated with increased extubation failure. It can be assessed by cough peak flow and the semiquantitative cough strength score (SCSS).
A spontaneous breathing experiment (SBT) has been proposed to assist in determining if a patient can be weaned off mechanical ventilation (MV). Extubation is suggested after a successful spontaneous breathing experiment (SBT).
However, extubation failure occurs in 10%–20% of patients who successfully complete an SBT. In comparison to patients who successfully extubate, those who fail to extubate are more likely to die in the hospital. Early identification of patients at high risk of extubation failure and prompt implementation of preventative interventions (e.g., noninvasive ventilation or the use of a high-flow nasal cannula) have been shown to minimise hospital mortality. As a result, the critical topic is how to identify individuals who are at increased risk of extubation failure.
Duan, J., Zhang, X. & Song, J. Predictive power of extubation failure diagnosed by cough strength: a systematic review and meta-analysis. Crit Care 25, 357 (2021). https://doi.org/10.1186/s13054-021-03781-5
Dr Monish Raut is a practising Cardiothoracic-Vascular Anesthesiologist. His clinical work is also enriched with his numerous academic publications in various national and international indexed journals. He has a keen interest in latest medical researches and updates particularly in critical care medicine, cardiology and anaesthesiology.