Duan Jun, Zhou Lintong, Xiao Meiling, Liu Jinhua, Yang Xiangmei
Jun Duan and Lintong Zhou are physicians and Meiling Xiao, Jinhua Liu, and Xiangmei Yang are nurses in the Department of Respiratory Medicine at the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Am J Crit Care. 2015 Nov;24(6):e86-90. doi: 10.4037/ajcc2015172.
Semiquantitative cough strength score (SCSS, graded 0-5) and cough peak flow (CPF) have been used to predict extubation outcome in patients in whom extubation is planned; however, the correlation of the 2 assessments is unclear.
In the intensive care unit of a university-affiliated hospital, 186 patients who were ready for extubation after a successful spontaneous breathing trial were enrolled in the study. Both SCSS and CPF were assessed before extubation. Reintubation was recorded 72 hours after extubation.
Reintubation rate was 15.1% within 72 hours after planned extubation. Patients in whom extubation was successful had higher SCSSs than did reintubated patients (mean [SD], 3.2 [1.6] vs 2.2 [1.6], P = .002) and CPF (74.3 [40.0] vs 51.7 [29.4] L/min, P = .005). The SCSS showed a positive correlation with CPF (r = 0.69, P < .001). Mean CPFs were 38.36 L/min, 39.51 L/min, 44.67 L/min, 57.54 L/min, 78.96 L/min, and 113.69 L/min in patients with SCSSs of 0, 1, 2, 3, 4, and 5, respectively. The discriminatory power for reintubation, evidenced by area under the receiver operating characteristic curve, was similar: 0.677 for SCSS and 0.678 for CPF (P = .97). As SCSS increased (from 0 to 1 to 2 to 3 to 4 to 5), the reintubation rate decreased (from 29.4% to 25.0% to 19.4% to 16.1% to 13.2% to 4.1%).
SCSS was convenient to measure at the bedside. It was positively correlated with CPF and had the same accuracy for predicting reintubation after planned extubation.
半定量咳嗽强度评分（SCSS，0 - 5级）和咳嗽峰值流速（CPF）已被用于预测计划拔管患者的拔管结局；然而，这两种评估方法之间的相关性尚不清楚。
在一所大学附属医院的重症监护病房，186例在成功进行自主呼吸试验后准备拔管的患者被纳入研究。在拔管前对SCSS和CPF进行评估。记录拔管后72小时内的再次插管情况。
计划拔管后72小时内再次插管率为15.1%。拔管成功的患者SCSS高于再次插管的患者（均值[标准差]，3.2[1.6]对2.2[1.6]，P = 0.002），CPF也更高（74.3[40.0]对51.7[29.4]L/分钟，P = 0.005）。SCSS与CPF呈正相关（r = 0.69，P < 0.001）。SCSS为0、1、2、3、4和5的患者，其平均CPF分别为38.36L/分钟、39.51L/分钟、44.67L/分钟、57.54L/分钟、78.96L/分钟和113.69L/分钟。通过受试者操作特征曲线下面积证明的对再次插管的辨别能力相似：SCSS为0.677，CPF为0.678（P = 0.97）。随着SCSS增加（从0到1到2到3到4到5），再次插管率降低（从29.4%到25.0%到19.4%到16.1%到13.2%到4.1%）。
SCSS在床边测量方便。它与CPF呈正相关，且在预测计划拔管后的再次插管方面准确性相同。
