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The effect of coughing at extubation on oxygenation in the post‐anaesthesia care unit
Summary We prospectively studied 84 patients to investigate whether there is a relationship between coughing during emergence and tracheal extubation, and impaired oxygenation in the post‐anaesthesia care unit. Our primary outcome measure was a change in the alveolar‐arterial oxygen partial pressure...
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| Published in: | Anaesthesia 2015-04, Vol.70 (4), p.416-420 |
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| Main Authors: | , , , |
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| cites | cdi_FETCH-LOGICAL-c3574-4c188c868d8411f0729c56653e9dd2f7ed22afc5685f27d11c9f4e46d4be89e33 |
| container_end_page | 420 |
| container_issue | 4 |
| container_start_page | 416 |
| container_title | Anaesthesia |
| container_volume | 70 |
| creator | Lumb, A. B. Bradshaw, K. Gamlin, F. M. C. Heard, J. |
| description | Summary
We prospectively studied 84 patients to investigate whether there is a relationship between coughing during emergence and tracheal extubation, and impaired oxygenation in the post‐anaesthesia care unit. Our primary outcome measure was a change in the alveolar‐arterial oxygen partial pressure gradient ((A‐a)DO2) between time A (during general anaesthesia) and time B (1 h after extubation). Patients demonstrated a worsening of oxygenation with mean (SD) (A‐a)DO2 increasing from 7.5 (5.2) kPa at time A to 13.9 (4.2) kPa at time B (p |
| doi_str_mv | 10.1111/anae.12924 |
| format | article |
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We prospectively studied 84 patients to investigate whether there is a relationship between coughing during emergence and tracheal extubation, and impaired oxygenation in the post‐anaesthesia care unit. Our primary outcome measure was a change in the alveolar‐arterial oxygen partial pressure gradient ((A‐a)DO2) between time A (during general anaesthesia) and time B (1 h after extubation). Patients demonstrated a worsening of oxygenation with mean (SD) (A‐a)DO2 increasing from 7.5 (5.2) kPa at time A to 13.9 (4.2) kPa at time B (p < 0.01). An overall linear regression model was not predictive for the observed change (adjusted R2 = 0.01, p = 0.31) and nor were any of the individual predictors studied, including subjective cough score (p = 0.33), number of coughs (p = 0.95) and duration of coughing (p = 0.39). Despite the abnormal cough that occurs while tracheally intubated, we have been unable to demonstrate that coughing at extubation is associated with impaired oxygenation in the immediate postoperative period.</description><identifier>ISSN: 0003-2409</identifier><identifier>EISSN: 1365-2044</identifier><identifier>DOI: 10.1111/anae.12924</identifier><identifier>PMID: 25376328</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Airway Extubation - adverse effects ; Airway Extubation - methods ; Anesthesia ; Anesthesia Recovery Period ; Anesthesia, General ; Cough - etiology ; Cough - physiopathology ; Female ; Humans ; Intubation ; Intubation, Intratracheal ; Male ; Middle Aged ; Oxygen - blood ; Oxygen Consumption - physiology ; Partial Pressure ; Postoperative period ; Prospective Studies ; Severity of Illness Index ; Young Adult</subject><ispartof>Anaesthesia, 2015-04, Vol.70 (4), p.416-420</ispartof><rights>2014 The Association of Anaesthetists of Great Britain and Ireland</rights><rights>2014 The Association of Anaesthetists of Great Britain and Ireland.</rights><rights>Copyright © 2015 The Association of Anaesthetists of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3574-4c188c868d8411f0729c56653e9dd2f7ed22afc5685f27d11c9f4e46d4be89e33</citedby><cites>FETCH-LOGICAL-c3574-4c188c868d8411f0729c56653e9dd2f7ed22afc5685f27d11c9f4e46d4be89e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25376328$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lumb, A. B.</creatorcontrib><creatorcontrib>Bradshaw, K.</creatorcontrib><creatorcontrib>Gamlin, F. M. C.</creatorcontrib><creatorcontrib>Heard, J.</creatorcontrib><title>The effect of coughing at extubation on oxygenation in the post‐anaesthesia care unit</title><title>Anaesthesia</title><addtitle>Anaesthesia</addtitle><description>Summary
We prospectively studied 84 patients to investigate whether there is a relationship between coughing during emergence and tracheal extubation, and impaired oxygenation in the post‐anaesthesia care unit. Our primary outcome measure was a change in the alveolar‐arterial oxygen partial pressure gradient ((A‐a)DO2) between time A (during general anaesthesia) and time B (1 h after extubation). Patients demonstrated a worsening of oxygenation with mean (SD) (A‐a)DO2 increasing from 7.5 (5.2) kPa at time A to 13.9 (4.2) kPa at time B (p < 0.01). An overall linear regression model was not predictive for the observed change (adjusted R2 = 0.01, p = 0.31) and nor were any of the individual predictors studied, including subjective cough score (p = 0.33), number of coughs (p = 0.95) and duration of coughing (p = 0.39). Despite the abnormal cough that occurs while tracheally intubated, we have been unable to demonstrate that coughing at extubation is associated with impaired oxygenation in the immediate postoperative period.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Airway Extubation - adverse effects</subject><subject>Airway Extubation - methods</subject><subject>Anesthesia</subject><subject>Anesthesia Recovery Period</subject><subject>Anesthesia, General</subject><subject>Cough - etiology</subject><subject>Cough - physiopathology</subject><subject>Female</subject><subject>Humans</subject><subject>Intubation</subject><subject>Intubation, Intratracheal</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Oxygen - blood</subject><subject>Oxygen Consumption - physiology</subject><subject>Partial Pressure</subject><subject>Postoperative period</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Young Adult</subject><issn>0003-2409</issn><issn>1365-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp9kE1OwzAQhS0EgvKz4QDIEhuEFPDYTuIsq6r8SAg2RSwj1xkXozYpcSLaHUfgjJwEhxQWLBhZGj3r85vxI-QY2AWEutSlxgvgGZdbZAAiiSPOpNwmA8aYiLhk2R7Z9_6FMeAK1C7Z47FIE8HVgDxNnpGitWgaWllqqnb27MoZ1Q3FVdNOdeOqknZntZ5h2UtX0iY8W1a--Xz_6Mb7oL3T1OgaaVu65pDsWD33eLTpB-TxajwZ3UR3D9e3o-FdZEScykgaUMqoRBVKAliW8szESRILzIqC2xQLzrUNVyq2PC0ATGYlyqSQU1QZCnFAznrfZV29tmGPfOG8wflcl1i1PockkRxYBllAT_-gL1Vbl2G7juJSKA5xoM57ytSV9zXafFm7ha7XObC8izvv_pt_xx3gk41lO11g8Yv-5BsA6IE3N8f1P1b58H447k2_AC-8iks</recordid><startdate>201504</startdate><enddate>201504</enddate><creator>Lumb, A. B.</creator><creator>Bradshaw, K.</creator><creator>Gamlin, F. M. C.</creator><creator>Heard, J.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201504</creationdate><title>The effect of coughing at extubation on oxygenation in the post‐anaesthesia care unit</title><author>Lumb, A. B. ; Bradshaw, K. ; Gamlin, F. M. C. ; Heard, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3574-4c188c868d8411f0729c56653e9dd2f7ed22afc5685f27d11c9f4e46d4be89e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Airway Extubation - adverse effects</topic><topic>Airway Extubation - methods</topic><topic>Anesthesia</topic><topic>Anesthesia Recovery Period</topic><topic>Anesthesia, General</topic><topic>Cough - etiology</topic><topic>Cough - physiopathology</topic><topic>Female</topic><topic>Humans</topic><topic>Intubation</topic><topic>Intubation, Intratracheal</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Oxygen - blood</topic><topic>Oxygen Consumption - physiology</topic><topic>Partial Pressure</topic><topic>Postoperative period</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lumb, A. B.</creatorcontrib><creatorcontrib>Bradshaw, K.</creatorcontrib><creatorcontrib>Gamlin, F. M. C.</creatorcontrib><creatorcontrib>Heard, J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Anaesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lumb, A. B.</au><au>Bradshaw, K.</au><au>Gamlin, F. M. C.</au><au>Heard, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of coughing at extubation on oxygenation in the post‐anaesthesia care unit</atitle><jtitle>Anaesthesia</jtitle><addtitle>Anaesthesia</addtitle><date>2015-04</date><risdate>2015</risdate><volume>70</volume><issue>4</issue><spage>416</spage><epage>420</epage><pages>416-420</pages><issn>0003-2409</issn><eissn>1365-2044</eissn><abstract>Summary
We prospectively studied 84 patients to investigate whether there is a relationship between coughing during emergence and tracheal extubation, and impaired oxygenation in the post‐anaesthesia care unit. Our primary outcome measure was a change in the alveolar‐arterial oxygen partial pressure gradient ((A‐a)DO2) between time A (during general anaesthesia) and time B (1 h after extubation). Patients demonstrated a worsening of oxygenation with mean (SD) (A‐a)DO2 increasing from 7.5 (5.2) kPa at time A to 13.9 (4.2) kPa at time B (p < 0.01). An overall linear regression model was not predictive for the observed change (adjusted R2 = 0.01, p = 0.31) and nor were any of the individual predictors studied, including subjective cough score (p = 0.33), number of coughs (p = 0.95) and duration of coughing (p = 0.39). Despite the abnormal cough that occurs while tracheally intubated, we have been unable to demonstrate that coughing at extubation is associated with impaired oxygenation in the immediate postoperative period.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>25376328</pmid><doi>10.1111/anae.12924</doi><tpages>5</tpages></addata></record> |
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| ispartof | Anaesthesia, 2015-04, Vol.70 (4), p.416-420 |
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| language | eng |
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| source | Wiley |
| subjects | Adult Aged Aged, 80 and over Airway Extubation - adverse effects Airway Extubation - methods Anesthesia Anesthesia Recovery Period Anesthesia, General Cough - etiology Cough - physiopathology Female Humans Intubation Intubation, Intratracheal Male Middle Aged Oxygen - blood Oxygen Consumption - physiology Partial Pressure Postoperative period Prospective Studies Severity of Illness Index Young Adult |
| title | The effect of coughing at extubation on oxygenation in the post‐anaesthesia care unit |
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