Recovery of cough after extubation after coronary artery bypass grafting: A prospective study

Abstract Purpose This study aims to evaluate the effect of intubation for coronary artery bypass grafting (CABG) on the cough reflex, an important airway protection mechanism. Materials Eighty-six participants (70 males) underwent cough reflex texting (CRT) before intubation for CABG to establish ba...

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Bibliographic Details
Published in:Journal of critical care 2015-08, Vol.30 (4), p.758-761
Main Authors: Kallesen, Molly, MSc, Psirides, Alex, MBBS, BSc (Hons), FCICM, Huckabee, Maggie-Lee, PhD
Format: Article
Language:English
Subjects:
Acids
Aged
Airway Extubation - adverse effects
CABG
Cardiac surgery
Coronary Artery Bypass
Cough - physiopathology
Cough reflex
Critical Care
Data analysis
Deaths
Deglutition Disorders - etiology
Dysphagia
Extubation
Female
Heart surgery
Hospitals
Humans
Intensive Care Units
Intubation
Male
Medical research
Middle Aged
Mortality
Narcotics
Pneumonia
Pneumonia, Aspiration - etiology
Population
Postoperative Complications
Prospective Studies
Recovery of Function
Reflex - physiology
Studies
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Summary:Abstract Purpose This study aims to evaluate the effect of intubation for coronary artery bypass grafting (CABG) on the cough reflex, an important airway protection mechanism. Materials Eighty-six participants (70 males) underwent cough reflex texting (CRT) before intubation for CABG to establish baseline threshold for reflexive cough. Cough reflex texting was repeated within 2 hours of extubation and every morning and evening thereafter until the participant coughed at baseline level, withdrew, or was discharged from hospital. Results Sixty percent of participants had an absent cough reflex at CRT2 (x = 70 minutes). Participants varied in time to recovery of cough reflex. By CRT6, only 3 remaining participants persisted with an absent cough. Age, sex, or length of intubation had no significant impact on the time to recovery of cough reflex ( P > .3). Conclusions Absent cough reflex persists after CABG and may impact patients' ability to clear their airway in the event of aspiration. These results could contribute to better understanding postextubation dysphagia. More research is needed to determine if cough reflex is affected in the wider intensive care unit population postextubation and if CRT is a valid tool for detecting silent aspiration in this population.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2015.03.013