Value of Peak Expiratory Flow Rate in Evaluating Cough Ability in Patients Undergoing Lung Surgery

Abstract

Introduction. Postoperative ineffective cough is easy to occur after thoracic surgery, and it is also a risk factor for postoperative pulmonary complications (PPCs). Objectives. To explore the value of peak expiratory flow rate (PEF) in evaluating cough ability in patients undergoing lung surgery and evaluate the effectiveness of chest wall compression during the expiratory phase by PEF. Methods. From September 2020 to May 2021, the researchers collected the data of patients who underwent lung surgery. Eventually, 153 patients who met the criteria were included, 102 cases were included in the effective cough group and 51 cases were included in the ineffective cough group. The receiver working curve (ROC curve) was used to analyze whether PEF could evaluate cough ability. At the same time, the researchers collected the pulmonary function data of the first 30 patients of the ineffective cough group while compressing the chest wall during the expiratory phase to evaluate the effectiveness of chest wall compression. Results. The area under the curve (AUC) of postoperative PEF to evaluate the postoperative cough ability was 0.955 (95% CI: 0.927–0.983, P < 0.001 ). The values of PEF (127.17 ± 34.72 L/min vs. 100.70 ± 29.98 L/min, P < 0.001 , 95% CI: 18.34–34.59) and FEV1 (0.72 (0.68–0.97) L vs. 0.64 (0.56–0.82) L, P < 0.001 ) measured while compressing the chest wall were higher than those without compression. Conclusions. PEF can be used as a quantitative indicator of cough ability. Chest wall compression could improve cough ability for patients who have ineffective cough.

Interest of the Leicester Cough Questionnaire in predicting postoperatives complications after lung resection: LCQ-SURGE

“…CPF has primarily been studied in patients with neuromuscular diseases and to predict the success of extubation in intensive care unit patients ( 27 ). Patients undergoing lung resection surgery experience a restrictive syndrome in the postoperative period due to the involvement of both the thoracic wall and lung parenchyma ( 28 ). Additionally, unilateral left vocal cord paralysis is a relatively common comorbidity in lung surgery ( 29 ).…”

A Prediction Model for Peak Expiratory Flow Derived From Venous Blood Biomarkers and Clinical Factors in Amyotrophic Lateral Sclerosis

“…The study reported that 85% of patients with ALS would develop dysphagia and impaired secretion management, leading to impairment of mucociliary clearing and airway protection (6), which resulted in malnutrition, dehydration, and aspiration pneumonia (7). PEF can be used as a tool for assessing cough ability for patients who underwent lung surgery (8), pulmonary function assessment before lung surgery (9,10), and airway clearance in neurodegenerative disease (11). Recent studies reported that respiratory impairments in patients with ALS demonstrated reduced peak expiratory flow (PEF) rates compared to healthy controls (12,13), implying that PEF may be a good screen tool for identifying patients with ALS at risk for aspiration (13).…”