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Cough Peak Flow (CPF) seems to be an efficient tool to assess cough capacity for the intensive care unit (ICU) ventilated patient. CPF can be used in the ventilator weaning process, as reflecting the upper airways protection capacity.
CPF requires disconnection of the patient from the ICU ventilator, supplemental material (handheld spirometer, antibacterial filter) and an excellent synchronization between the specialized caregiver and the patient.
We aimed that CPF with the ventilator built-in flow-meter is correlated with CPF using a handheld flowmeter connected to the endotracheal tube.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| cough peak flow measurement | All enrolled patients will undergo measurement of cough peak flow by two methods, i.e. using a handheld electronic spirometer, and using the ventilator flowmeter, in a randomized order. |
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| Measure | Description | Time Frame |
|---|---|---|
| Correlation coefficient for the two CPF assessment methods, on extubation day | Correlation coefficient for the two CPF assessment methods, on extubation day | Within 1 hour before mechanical ventilation termination (extubation) |
| Measure | Description | Time Frame |
|---|---|---|
| Discriminatory power of CPF to predict successful weaning of mechanical ventilation, i.e. no reintubation within 72 hours after extubation, or unsuccessful weaning. | Thresholds of CPF will be tested as predictors of weaning success | During the mechanical ventilation until 72 hours post extubation |
| Assess the correlation between CPF and length of mechanical ventilation |
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Inclusion Criteria:
Exclusion Criteria:
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Critically ill patients undergoing invasive mechanical ventilation, sufficiently awake and cooperative to be assessed for their cough strength.
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| Name | Affiliation | Role |
|---|---|---|
| Guillaume FOSSAT | CHR Orléans | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHR d'Orléans | Orléans | 45000 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 12853532 | Background | Smina M, Salam A, Khamiees M, Gada P, Amoateng-Adjepong Y, Manthous CA. Cough peak flows and extubation outcomes. Chest. 2003 Jul;124(1):262-8. doi: 10.1378/chest.124.1.262. | |
| 20097804 | Background | Su WL, Chen YH, Chen CW, Yang SH, Su CL, Perng WC, Wu CP, Chen JH. Involuntary cough strength and extubation outcomes for patients in an ICU. Chest. 2010 Apr;137(4):777-82. doi: 10.1378/chest.07-2808. Epub 2010 Jan 22. |
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| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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Assess the correlation between CPF and length of mechanical ventilation |
| During the mechanical ventilation until 72 hours post extubation |
| 3. Correlation between the two CPF assessment methods the days before extubation | 3. Correlation between the two CPF assessment methods the days before extubation | During the mechanical ventilation until 72 hours post extubation |
| 23013898 | Background | Macintyre NR. Evidence-based assessments in the ventilator discontinuation process. Respir Care. 2012 Oct;57(10):1611-8. doi: 10.4187/respcare.02055. |
| 23641924 | Background | Thille AW, Richard JC, Brochard L. The decision to extubate in the intensive care unit. Am J Respir Crit Care Med. 2013 Jun 15;187(12):1294-302. doi: 10.1164/rccm.201208-1523CI. |