Cough Peak Flow as a Predictor of Pulmonary Morbidity in Patients with Dysphagia

被引:47
作者
Bianchi, Carlo [2 ]
Baiardi, Paola [4 ]
Khirani, Sonia [3 ]
Cantarella, Giovanna [1 ]
机构
[1] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dept Otolaryngol, I-20122 Milan, Italy
[2] Fdn Don Carlo Gnocchi, Ctr IRCCS Santa Maria Nascente, Rehabil Unit, Milan, Italy
[3] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dept Bronchopneumol, I-20122 Milan, Italy
[4] Consorzio Valutaz Biol & Farmacol, Pavia, Italy
关键词
Aspiration; Deglutition; Deglutition Disorders; Voluntary Cough; Aspiration Pneumonia; Respiratory Prognosis; Cough Efficacy; ASPIRATION PNEUMONIA;
D O I
10.1097/PHM.0b013e3182556701
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Bianchi C, Baiardi P, Khirani S, Cantarella G: Cough peak flow as a predictor of pulmonary morbidity in patients with dysphagia. Am J Phys Med Rehabil 2012; 91: 783-788. Objective: The aim of this study was to ascertain whether an objective cough measure relates to the risk of pulmonary complications in dysphagic patients with persistent tracheobronchial aspiration. Design: This is a retrospective observational study involving 55 dysphagic patients who underwent a modified barium swallow study and pulmonary function tests including cough peak flow measurement. The results were compared between subjects with and without pulmonary complications because of aspiration. Results: The 18 patients (33%) with pulmonary complications had significantly lower mean cough peak flow values (202.2 +/- 68.8 vs. 303.9 +/- 80.7 liters/min; P < 0.001) than those without pulmonary complications. The finding of tracheobronchial coating in a modified barium swallow was not related to the occurrence of pulmonary morbidity. Receiver operating characteristic curve analysis showed that a CPF level lower than 242 liters/min predicted the development of pulmonary complications with a sensitivity of 77% and a specificity of 83%; the positive and negative predictive values were 65% and 90%, respectively. Conclusions: Our findings indicate that cough peak flow is a valuable predictor of respiratory prognosis in chronic aspiration. This finding suggests a new rehabilitation strategy aimed at improving cough flows for dysphagic patients.
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页码:783 / 788
页数:6
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