Assessing the reproducibility and predictive value of objective cough measurement for successful withdrawal of invasive ventilatory support in adult patients.
BMC Pulm Med
; 24(1): 218, 2024 May 02.
Article
em En
| MEDLINE
| ID: mdl-38698348
ABSTRACT
BACKGROUND:
Utilizing clinical tests, such as objective cough measurement, can assist in predicting the success of the weaning process in critically ill patients.METHODS:
A multicenter observational analytical study was conducted within a prospective cohort of patients recruited to participate in COBRE-US. We assessed the capability of objective cough measurement to predict the success of the spontaneous breathing trial (SBT) and extubation. Intra- and inter-observer reproducibility of the cough test and was evaluated using the intraclass correlation coefficient (ICC) and Cohen's weighted kappa. We used receiver operating characteristic curves (ROC-curve) to evaluate the predictive ability of objective cough measurement.RESULTS:
We recruited 367 subjects who were receiving invasive mechanical ventilation. A total of 451 objective cough measurements and 456 SBTs were conducted. A significant association was found between objective cough measurement and successful SBT (OR 1.68; 95% CI 1.48-1.90; p = 0.001). The predictive capability of the objective cough test for SBT success had a ROC-curve of 0.58 (95% CI 0.56-0.61). Objective cough measurement to predict successful extubation had a ROC-curve of 0.61 (95% CI 0.56-0.66). The intraobserver reproducibility exhibited an ICC of 0.94 (95% CI 0.89-0.96; p < 0.001), while the interobserver reproducibility demonstrated an ICC of 0.72 (95% CI 0.51-0.85; p < 0.001). The intraobserver agreement, assessed using Cohen's weighted kappa was 0.94 (95% CI 0.93-0.99; p < 0.001), whereas the interobserver agreement was 0.84 (95% CI 0.67 - 0.10; p < 0.001).CONCLUSIONS:
The objective measurement of cough using the method employed in our study demonstrates nearly perfect intra-observer reproducibility and agreement. However, its ability to predict success or failure in the weaning process is limited.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Desmame do Respirador
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Curva ROC
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Tosse
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Extubação
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
BMC Pulm Med
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Colômbia
País de publicação:
Reino Unido