Effects of cough enhancement techniques on weaning in adult patients under mechanical ventilation:a systematic review
10.3969/j.issn.1671-8283.2025.04.011
- VernacularTitle:咳嗽增强技术对成人机械通气患者撤机效果的系统评价
- Author:
Qian CHEN
1
;
Junjun ZOU
1
;
Chunyang XU
1
;
Lihua GU
1
;
Xiaojuan JIANG
1
;
Mengqian GU
1
Author Information
1. 常熟市第一人民医院急诊医学科,江苏常熟,215500
- Publication Type:Journal Article
- Keywords:
cough enforcement techniques;
mechanical ventilation;
weaning;
systematic review
- From:
Modern Clinical Nursing
2025;24(4):81-91
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the impact of cough enhancement techniques on weaning outcomes in adult patients under mechanical ventilation(MV).Methods Databases from the inception to 15th November,2024 were searched for randomised controlled trials(RCTs)on cough enhancement technique in MV patients.The searched databases were CNKI,Wanfang Data base,SinoMed,Vip,PubMed,Web of Science,Cochrane Library,Embase,and CINAHL.Literature and evidence quality were evaluated using Cochrane's evaluation tool for intervention research and the GRADE system,and data were extracted and analysed via Meta-analysis with Review Manager 5.3.Results A total of 27 studies were included,involving 2,322 patients(1,169 in the trial group and 1,153 in the control group).Compared with the control group,the trial group had shorter time of mechanical ventilation[MD=-1.40,95%CI(-1.83,-0.97),P<0.001],lower weaning failure rate[OR=0.48,95%CI(0.27,0.85),P=0.01],higher oxygenation index[MD=35.48,95%CI(21.53,49.43),P<0.001],lower pulmonary atelectasis incidence[OR=0.30,95%CI(0.18,0.49),P<0.001],greater sputum volume[MD=1.88,95%CI(0.76,3.01),P=0.001],shorter ICU stay[MD=-1.90,95%CI(-2.95,-0.85),P<0.001]and lower serum procalcitonin(PCT)[MD=-0.89,95%CI(-1.64,-0.14),P=0.02],all with statistically significant differences.However,there was no significant difference in the ventilator-associated pneumonia(VAP)between the two groups[OR=0.54,95%CI(0.21,1.35),P=0.19].Conclusion Cough enhancement techniques promote sputum discharge,improve infection and oxygenation,shorten mechanical ventilation and ICU stay,reduce weaning failure and atelectasis rates in MV patients.Further studies are required to reduce the incidence of VAP.
