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Cough is seen to occur commonly in post cardiac surgery patients. This causes great discomfort by aggravating pain. Sufficient data are not available regarding the incidence and cause of this cough. Study was designed to assess the severity and progress of cough in each postoperative day, the difference in cough pattern between various cardiac diseases and surgical techniques, the influence of smoking, the relationship to fluid imbalance and the relationship to reduction of lung volume and its influence on cough pattern. Material and Methods: 100 consecutive adult patients who underwent cardiac surgery in this centre were evaluated for cough. Those who needed prolonged ventilation or developed respiratory infection were excluded. The incidence and intensity of cough was compared between the type of surgeries, cardiac pathology, smoking habits, fluid balance, and the lung volume of the patient. Results: Over 80% of patients were found to have cough with, intensity peaking by 3rdto 5th post operative day (POD) and gradually reducing by 8th POD. Even in 8th POD,74 patients had cough with 11 having moderate to severe cough and 63 mild. The incidence of cough was found to be similar irrespective of technique of surgery, smoking habits and fluid balance. No significant variation with cardiopulmonary bypass (CPB) time (p-0.44), ejection fraction (p-0.88) and number of grafts in off pump patients (p-1.00) were seen. Conclusion: 80% of post cardiac surgery patients were found to have cough, with varying intensity. Reduction in lung volume, as assessed by breath holding capacity, was seen in majority of patients. Incidence of cough was found to occur more when breath holding capacity reduces to less than 65% of preoperative level (P 0.00).

Non Infective Cough in Immediate Post Cardiac Surgery Patients