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Comparison of “cough peak expiratory flow measurement” and “cough strength measurement using the white card test” in extubation success: A randomized controlled trial

BACKGROUND: Failed extubation and subsequent re-intubation in ventilated patients can lead to many adverse consequences, including organizational and personal expenditures. Extubation decisions based on subjective methods are a major contributor to extubation failure. This study compared the effect...

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Autores principales: Abedini, Mohsen, Froutan, Razieh, Bagheri Moghaddam, Ahmad, Mazloum, Seyed Reza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377116/
https://www.ncbi.nlm.nih.gov/pubmed/32765622
http://dx.doi.org/10.4103/jrms.JRMS_939_19
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author Abedini, Mohsen
Froutan, Razieh
Bagheri Moghaddam, Ahmad
Mazloum, Seyed Reza
author_facet Abedini, Mohsen
Froutan, Razieh
Bagheri Moghaddam, Ahmad
Mazloum, Seyed Reza
author_sort Abedini, Mohsen
collection PubMed
description BACKGROUND: Failed extubation and subsequent re-intubation in ventilated patients can lead to many adverse consequences, including organizational and personal expenditures. Extubation decisions based on subjective methods are a major contributor to extubation failure. This study compared the effect of cough peak expiratory flow (PEF) measurement and cough strength measurement using the white card test (WCT) on extubation success. MATERIALS AND METHODS: This randomized clinical trial was conducted in two groups in 2018 on 88 ventilated patients in intensive care units of Imam Reza Hospital in Mashhad, Iran. Ninety patients were divided into two groups of 45, but two were excluded from the white card group. The criteria established for extubation included PEF ≥60 L/min during coughing in the cough PEF group and noticing card humidity in the WCT group. In both groups, extubation success was determined as the sole outcome and was compared with the standard PEF and cough strength. The researcher who assessed the outcome and statistician were blinded about group allocation. RESULTS: Extubation success was measured as 97.8% in the cough PEF group and 76.7% in the WCT group (P = 0.003) during the first 24 h. In the second 24 h, however, successful extubation was reported as 90.9% in the cough PEF group and 60.6% in the WCT group (P = 0.002). CONCLUSION: Using the cough PEF rate increases the likelihood of extubation success and reduces adverse effects, and is recommended to be used for extubation decision-making.
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spelling pubmed-73771162020-08-05 Comparison of “cough peak expiratory flow measurement” and “cough strength measurement using the white card test” in extubation success: A randomized controlled trial Abedini, Mohsen Froutan, Razieh Bagheri Moghaddam, Ahmad Mazloum, Seyed Reza J Res Med Sci Original Article BACKGROUND: Failed extubation and subsequent re-intubation in ventilated patients can lead to many adverse consequences, including organizational and personal expenditures. Extubation decisions based on subjective methods are a major contributor to extubation failure. This study compared the effect of cough peak expiratory flow (PEF) measurement and cough strength measurement using the white card test (WCT) on extubation success. MATERIALS AND METHODS: This randomized clinical trial was conducted in two groups in 2018 on 88 ventilated patients in intensive care units of Imam Reza Hospital in Mashhad, Iran. Ninety patients were divided into two groups of 45, but two were excluded from the white card group. The criteria established for extubation included PEF ≥60 L/min during coughing in the cough PEF group and noticing card humidity in the WCT group. In both groups, extubation success was determined as the sole outcome and was compared with the standard PEF and cough strength. The researcher who assessed the outcome and statistician were blinded about group allocation. RESULTS: Extubation success was measured as 97.8% in the cough PEF group and 76.7% in the WCT group (P = 0.003) during the first 24 h. In the second 24 h, however, successful extubation was reported as 90.9% in the cough PEF group and 60.6% in the WCT group (P = 0.002). CONCLUSION: Using the cough PEF rate increases the likelihood of extubation success and reduces adverse effects, and is recommended to be used for extubation decision-making. Wolters Kluwer - Medknow 2020-05-22 /pmc/articles/PMC7377116/ /pubmed/32765622 http://dx.doi.org/10.4103/jrms.JRMS_939_19 Text en Copyright: © 2020 Journal of Research in Medical Sciences http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Abedini, Mohsen
Froutan, Razieh
Bagheri Moghaddam, Ahmad
Mazloum, Seyed Reza
Comparison of “cough peak expiratory flow measurement” and “cough strength measurement using the white card test” in extubation success: A randomized controlled trial
title Comparison of “cough peak expiratory flow measurement” and “cough strength measurement using the white card test” in extubation success: A randomized controlled trial
title_full Comparison of “cough peak expiratory flow measurement” and “cough strength measurement using the white card test” in extubation success: A randomized controlled trial
title_fullStr Comparison of “cough peak expiratory flow measurement” and “cough strength measurement using the white card test” in extubation success: A randomized controlled trial
title_full_unstemmed Comparison of “cough peak expiratory flow measurement” and “cough strength measurement using the white card test” in extubation success: A randomized controlled trial
title_short Comparison of “cough peak expiratory flow measurement” and “cough strength measurement using the white card test” in extubation success: A randomized controlled trial
title_sort comparison of “cough peak expiratory flow measurement” and “cough strength measurement using the white card test” in extubation success: a randomized controlled trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377116/
https://www.ncbi.nlm.nih.gov/pubmed/32765622
http://dx.doi.org/10.4103/jrms.JRMS_939_19
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