The Predictive Value Of Cough Ability Grading Before Extubation In ICU Patients Undergoing Mechanical Ventilation

Objective: To explore the predictive value of cough ability grading for extubation outcome of mechanical ventilation patients in ICU,and to provide the basis for the application of cough ability grading in clinic,so as to improve the success rate of extubation and reduce the rate of secondary endotracheal intubation.Methods: The clinical data of mechanically ventilated patients admitted to a comprehensive tertiary care hospital in Lanzhou City from January 2022 to December2022 in the comprehensive ICU were collected and divided into extraction success group and failure group according to the extubation outcome,and the cough ability grading before extubation was compared between the two groups to analyze the predictive value of cough ability grading on the extubation outcome of mechanically ventilated patients.Results:1.In this study,the clinical data of 545 patients admitted to a tertiary care hospital in Lanzhou for mechanical ventilation with tracheal intubation were screened,and 265 patients were finally included according to the inclusion and exclusion criteria,of which 197 patients were successfully extubated and 68 patients failed to be extubated for secondary tracheal intubation,with a secondary tracheal intubation rate of 25.7%.2.The analysis found that an ROX index greater than 8.73 and a cough capacity rating of 4 or higher were protective factors against extubation failure in mechanically ventilated patients,and the duration of mechanical ventilation greater than 2.5 days(60 hours)was a risk factor for extubation failure.each 1-point increase in ROX index was associated with a 0.802-fold reduction in the risk of extubation failure [OR=0.802,95% CI(0.722,0.891),P <0.05].The risk of extubation failure increased 1.298 times for each day increase in the duration of mechanical ventilation [OR=1.298,95%CI(1.147,1.468),P<0.05],and the risk of extubation failure was 6.677 times higher for cough capacity grade 2-3 than for grade 4-5 [OR=6.677,95%CI(2.440,18.269),P<0.05].Conclusion: This study found that the rate of secondary tracheal intubation in mechanically ventilated patients in ICU was 25.7%,and high ROX index and high cough ability grading were protective factors for extubation failure in mechanically ventilated patients,and long duration of mechanical ventilation was a risk factor for extubation failure.the lower the ROX index,the longer the duration of mechanical ventilation,and the lower the cough ability grading,the higher the extubation failure rate.