Factors and potential treatments of cough after pulmonary resection: A systematic review

Li, Xin; Li, Xizhe; Zhang, Wuyang; Liu, Qi; Gao, Yang; Chang, Ruimin; Zhang, Chunfang

doi:10.1016/j.asjsur.2021.01.001

Cited by 15 publications

(20 citation statements)

References 71 publications

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“…CAP is defined as a dry cough lasting no less than two weeks following pneumonectomy with no obvious abnormality present in a chest x-ray ( 3 ). The effects of factors such as postnasal drip syndrome, bronchial asthma, and oral angiotensin converting enzyme inhibitor (ACEI) drugs are excluded ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of Preserving the Pulmonary Vagus Nerve Branches on Cough After Pneumonectomy During Video-Assisted Thoracic Surgery

Wang

et al. 2022

Front. Oncol.

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BackgroundCough is one of the most common complications of early-stage non-small cell lung cancer (NSCLC) after video-assisted thoracoscopic surgery (VATS). The vagus nerve plays an important role in pulmonary inflammation and the cough reflex. In this study, we attempted to reduce the incidence of postoperative chronic cough and other complications by preserving the pulmonary vagus nerve branches.Patients and MethodsThis study was a randomized controlled double-blinded trial of subjects and observers. A total of 158 NSCLC patients were enrolled. We randomly assigned 79 patients to Group A (pulmonary branch of vagus nerve preservation group) and 79 cases to Group B (conventional surgical treatment group). In the final analysis, 72 patients from Group A and 69 patients from Group B were included. The main outcome measure of the study was the occurrence of CAP or other postoperative complications within five weeks. This trial was registered with ClinicalTrials.gov (number NCT03921828).ResultsThere was no significant difference in preoperative general clinical data between the two groups. No death during the perioperative period occurred in either of the two groups. There was no significant difference between the two groups in operation time, intraoperative bleeding, number of lymph nodes sent for examination, number of cases transferred to ICU after operation, postoperative catheterization time, or postoperative hospital stay (P>0.05). There was no significant difference in other pulmonary and cardiovascular complications between the two groups, including pulmonary infection (2.78% vs. 8.70%, P = 0.129), atelectasis (1.39% vs. 0%, P = 0.326), pleural effusion (2.78% vs. 1.45%, P = 0.585), persistent pulmonary leakage (2.78% vs. 2.90%, P = 0.965), arrhythmia (2.78% vs. 1.45%, P = 0.585), and heart failure (0% vs. 1.45%, P = 0.305). The incidence of CAP in Group A was significantly lower than that in Group B (13.89% vs. 30.43%, P = 0.018). The LCQ-MC scores in Group A were significantly higher than those in Group B at two and five weeks after operation (P<0.05). Univariate and multivariate analysis showed that the risk factors for postoperative CAP were surgical side (right lung), surgical lung lobe (upper lobe), preservation of pulmonary branch of the vagus nerve during operation, and duration of anesthesia.ConclusionsPreserving the pulmonary vagus nerve branches during VATS in patients with stage IA1-2 NSCLC can reduce the incidence of postoperative CAP.

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Section: Introductionmentioning

confidence: 99%

Effects of Preserving the Pulmonary Vagus Nerve Branches on Cough After Pneumonectomy During Video-Assisted Thoracic Surgery

Wang

et al. 2022

Front. Oncol.

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“…Cough is a common complication after pulmonary resection [ 21 ]. To exclude the effect of preoperative cough symptoms, we excluded patients with preoperative cough to better investigate postoperative cough caused by pulmonary resection.…”

Section: Discussionmentioning

confidence: 99%

Lymph Node Dissection Is a Risk Factor for Short-Term Cough after Pulmonary Resection

Xing

Chen

et al. 2022

Current Oncology

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Cough is a common complication after pulmonary resection. However, the factors associated with cough that develop after pulmonary resection are still controversial. In this study, we used the Simplified Cough Score (SCS) and the Leicester Cough Questionnaire (LCQ) score to investigate potential risk factors for postoperative cough. Between January 2017 and June 2021, we collected the clinical data of 517 patients, the SCS at three days after surgery and the LCQ at two weeks and six weeks after surgery. Then, univariate and multivariate analyses were used to identify the independent risk factors for postoperative cough. The clinical baseline data of the cough group and the non-cough group were similar. However, the cough group had longer operation time and more blood loss. The patients who underwent lobectomy were more likely to develop postoperative cough than the patients who underwent segmentectomy and wedge resection, while the patients who underwent systematic lymph node dissection were more likely to develop postoperative cough than the patients who underwent lymph node sampling and those who did not undergo lymph node resection. When the same lymph node management method was applied, there was no difference in the LCQ scores between the patients who underwent wedge resection, lobectomy and segmentectomy. The lymph node resection method was an independent risk factor for postoperative cough (p < 0.001). Conclusions: Lymph node resection is an independent risk factor for short-term cough after pulmonary resection with video-assisted thoracoscopic surgery, and damage to the vagus nerve and its branches (particularly the pulmonary branches) is a possible cause of short-term cough. The mechanism of postoperative cough remains to be further studied.

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“…Given the exploding phase of the first part of a cough [ 34 ], the assumption was that the ratio between the energy peaks of the first part and second part of a cough event would usually have higher values than other sounds ( Fig 4C ).…”

Section: Methodsmentioning

confidence: 99%

Cough detection using a non-contact microphone: A nocturnal cough study

2022

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An automatic non-contact cough detector designed especially for night audio recordings that can distinguish coughs from snores and other sounds is presented. Two different classifiers were implemented and tested: a Gaussian Mixture Model (GMM) and a Deep Neural Network (DNN). The detected coughs were analyzed and compared in different sleep stages and in terms of severity of Obstructive Sleep Apnea (OSA), along with age, Body Mass Index (BMI), and gender. The database was composed of nocturnal audio signals from 89 subjects recorded during a polysomnography study. The DNN-based system outperformed the GMM-based system, at 99.8% accuracy, with a sensitivity and specificity of 86.1% and 99.9%, respectively (Positive Predictive Value (PPV) of 78.4%). Cough events were significantly more frequent during wakefulness than in the sleep stages (p < 0.0001) and were significantly less frequent during deep sleep than in other sleep stages (p < 0.0001). A positive correlation was found between BMI and the number of nocturnal coughs (R = 0.232, p < 0.05), and between the number of nocturnal coughs and OSA severity in men (R = 0.278, p < 0.05). This non-contact cough detection system may thus be implemented to track the progression of respiratory illnesses and test reactions to different medications even at night when a contact sensor is uncomfortable or infeasible.

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Factors and potential treatments of cough after pulmonary resection: A systematic review

Cited by 15 publications

References 71 publications

Effects of Preserving the Pulmonary Vagus Nerve Branches on Cough After Pneumonectomy During Video-Assisted Thoracic Surgery

Effects of Preserving the Pulmonary Vagus Nerve Branches on Cough After Pneumonectomy During Video-Assisted Thoracic Surgery

Lymph Node Dissection Is a Risk Factor for Short-Term Cough after Pulmonary Resection

Cough detection using a non-contact microphone: A nocturnal cough study

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