{"title":"Factors related to cough strength before tracheal extubation in post-cardiac surgery patients: A cross-sectional study.","authors":"Yan Zhang, Zheng Lin, Yuhong Chen, Liang Hong, Jing Chen, Zhongkang Wu, Xiao Shen","doi":"10.1111/nicc.13216","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tracheal extubation failure after cardiac surgery is associated with diminished cough strength, albeit the information on cough strength in post-cardiac surgery patients is limited.</p><p><strong>Aim: </strong>To investigate the cough strength in patients after cardiac surgery before tracheal extubation and the related influencing factors.</p><p><strong>Study design: </strong>A cross-sectional study was designed, with adherence to the STROBE guidelines. The participants were 528 patients undergoing open-heart cardiac surgery who were admitted to the Cardio Surgical Centre in a tertiary hospital in Nanjing, China, from August 2022 to September 2023. Cough peak flow (CPF) ≤60 L/min set as the cut-off value for evaluating diminished cough strength before tracheal extubation. Univariate analysis and multiple linear regression analysis were used to analyse the related influencing factors.</p><p><strong>Results: </strong>The mean CPF was 130.70 ± 50.58 L/min. A total of 76 (14.4%) patients exhibited a CPF of ≤60 L/min. Multiple linear regression analysis revealed that gender (B = 14.266, t = 2.456, p = .014), inspiratory capacity (IC) (B = 0.013, t = 3.755, p < .001), preoperative CPF (B = 0.086, t = 3.903, p < .001), muscle strength (B = 12.423, t = 4.242, p < .001), preoperative exercise regimen (B = 16.716, t = 4.236, p < .001) and pain levels (B = -8.115, t = -5.794, p < .001) significantly contributed to cough strength.</p><p><strong>Conclusions: </strong>Female gender, lower upper limb muscle strength, higher pain levels, lower preoperative CPF and IC, and the absence of systematic exercise were found to be associated with diminished cough strength.</p><p><strong>Relevance to clinical practice: </strong>Cough strength provides important auxiliary data in extubation decision-making. In addition, understanding its relevant factors can help identify the high-risk group of tracheal extubation failure and can help provide a strong theoretical basis for the development of personalized interventions.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nursing in Critical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/nicc.13216","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Tracheal extubation failure after cardiac surgery is associated with diminished cough strength, albeit the information on cough strength in post-cardiac surgery patients is limited.
Aim: To investigate the cough strength in patients after cardiac surgery before tracheal extubation and the related influencing factors.
Study design: A cross-sectional study was designed, with adherence to the STROBE guidelines. The participants were 528 patients undergoing open-heart cardiac surgery who were admitted to the Cardio Surgical Centre in a tertiary hospital in Nanjing, China, from August 2022 to September 2023. Cough peak flow (CPF) ≤60 L/min set as the cut-off value for evaluating diminished cough strength before tracheal extubation. Univariate analysis and multiple linear regression analysis were used to analyse the related influencing factors.
Results: The mean CPF was 130.70 ± 50.58 L/min. A total of 76 (14.4%) patients exhibited a CPF of ≤60 L/min. Multiple linear regression analysis revealed that gender (B = 14.266, t = 2.456, p = .014), inspiratory capacity (IC) (B = 0.013, t = 3.755, p < .001), preoperative CPF (B = 0.086, t = 3.903, p < .001), muscle strength (B = 12.423, t = 4.242, p < .001), preoperative exercise regimen (B = 16.716, t = 4.236, p < .001) and pain levels (B = -8.115, t = -5.794, p < .001) significantly contributed to cough strength.
Conclusions: Female gender, lower upper limb muscle strength, higher pain levels, lower preoperative CPF and IC, and the absence of systematic exercise were found to be associated with diminished cough strength.
Relevance to clinical practice: Cough strength provides important auxiliary data in extubation decision-making. In addition, understanding its relevant factors can help identify the high-risk group of tracheal extubation failure and can help provide a strong theoretical basis for the development of personalized interventions.
期刊介绍：
Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics.
Papers published in the journal normally fall into one of the following categories:
-research reports
-literature reviews
-developments in practice, education or management
-reflections on practice
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
