Spontaneous cough in extubation of non-comatose neurocritical patients
10.3760/cma.j.issn.1671-8925.2014.03.017
- VernacularTitle:自主咳嗽在非昏迷神经危重症患者拔管中的作用
- Author:
Lili ZHANG
1
;
Shengnan WANG
;
Zhenzhou LIN
;
Yongming WU
;
Suyue PAN
Author Information
1. 南方医科大学南方医院神经内科
- Keywords:
Neurocritical ill;
Extubation;
Spontaneous cough;
Non-comatose
- From:
Chinese Journal of Neuromedicine
2014;13(3):296-300
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between spontaneous cough and extubation outcome (EO) in non-comatose neurocritical patients.Methods A retrospective study was performed in patients admitted to the neurocritical care unit (NICU) from September 2011 to September 2012; the extubation decisions in these patients had been made by physicians based on an existing extubation protocol of NICU.We compared the baseline information,traditional weaning parameters (TWPs),Glasgow coma scale (GCS) scores,eye response scores,motor response scores,ability to follow four commands (closing eyes,showing two fingers,wiggling toes,coughing according to command) and existence of spontaneous cough between extubation failure (EF) and extubation success (ES) the patients.Results A total of 145 patients experienced episodes with artificial airway,resulting in 27 extubation attempts with 70.4％ (19/27) of ES and 29.6％ (8/27) of EF.There were no differences in baseline information and TWPs (P＞0.05),while significant differences in scores of GCS,eye response and motor response between ES and EF patients (P＜0.05).The cut-off value of GCS scores at the time of extubation was 10.5 (P=0.009).The ability to follow the four commands was not associated with extubation outcome (P=0.206).The existence of spontaneous cough strongly predicted ES (P=0.000),and when subgroup analysis was done for patients who could not follow four commands,the association was still remarkable (P=0.002).Conclusion Spontaneous cough could be a predictor of ES in non-comatose NICU patients,even in those who could not follow commands.
