Correlation of Two Methods for Cough Peak Flow Measurement in Intubated Patients

Study Overview
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Brief Summary
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Cough Peak Flow (CPF) seems to be an efficient tool to assess cough capacity for the intensive care unit (ICU) ventilated patient. CPF can be used in the ventilator weaning process, as reflecting the upper airways protection capacity. CPF requires disconnection of the patient from the ICU ventilator, supplemental material (handheld spirometer, antibacterial filter) and an excellent synchronization between the specialized caregiver and the patient. We aimed that CPF with the ventilator built-in flow-meter is correlated with CPF using a handheld flowmeter connected to the endotracheal tube.

Official Title
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Correlation of Cough Peak Flow Measurement by an Electronic Handheld Spirometer Connected to the Endotracheal Tube and by the Intensive Care Unit Ventilator Flowmeter.

Conditions
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Respiratory Insufficiency, Ventilator Weaning

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age > 18 years Mechanically ventilated patient > 24 hours Weaning ventilator phase (PEEP < 9 cmH2O and Support < 15 cm H2O) Richmond Agitation Sedation Scale between -1 and +1 Patient's agreement to participate Exclusion Criteria: Pregnant women Bronchospasm FiO2 > 70% Thoracic surgery < 7 days Abdominal surgery < 7 days Thoracic injury with rib fracture < 21 days Pneumothorax < 24 hours

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| cough peak flow measurement<br>All enrolled patients will undergo measurement of cough peak flow by two methods, i.e. using a handheld electronic spirometer, and using the ventilator flowmeter, in a randomized order. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation coefficient for the two CPF assessment methods, on extubation day | Correlation coefficient for the two CPF assessment methods, on extubation day | Within 1 hour before mechanical ventilation termination (extubation) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Discriminatory power of CPF to predict successful weaning of mechanical ventilation, i.e. no reintubation within 72 hours after extubation, or unsuccessful weaning. | Thresholds of CPF will be tested as predictors of weaning success | During the mechanical ventilation until 72 hours post extubation | 
| Assess the correlation between CPF and length of mechanical ventilation | Assess the correlation between CPF and length of mechanical ventilation | During the mechanical ventilation until 72 hours post extubation | 
| 3. Correlation between the two CPF assessment methods the days before extubation | 3. Correlation between the two CPF assessment methods the days before extubation | During the mechanical ventilation until 72 hours post extubation |