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The effect of coughing at extubation on oxygenation in the post‐anaesthesia care unit
Author(s) -
Lumb A. B.,
Bradshaw K.,
Gamlin F. M. C.,
Heard J.
Publication year - 2015
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.12924
Subject(s) - medicine , oxygenation , anesthesia , general anaesthesia
Summary 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)DO 2 ) between time A (during general anaesthesia) and time B (1 h after extubation). Patients demonstrated a worsening of oxygenation with mean (SD) (A‐a)DO 2 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.