The effect of coughing at extubation on oxygenation in the post-anaesthesia care unit.
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 R(2) = 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.
St James's University Hospital, Leeds, UK.
A B
AB
Lumb
K
K
Bradshaw
F M C
FM
Gamlin
J
J
Heard
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060666:Airway Extubation / Q000009:adverse effects* / Q000379:methods; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D003371:Cough / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology*; D010313:Partial Pressure; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
D010100:Oxygen