Recovery of cough after extubation after coronary artery bypass grafting: A prospective study

Purpose: This study aims to evaluate the effect of intubation for coronary artery bypass grafting (CABG) on the cough reflex, an important airway protection mechanism. Materials: Eighty-six participants (70 males) underwent cough reflex texting (CRT) before intubation for CABG to establish baseline threshold for reflexive cough. Cough reflex texting was repeated within 2 hours of extubation and every morning and evening thereafter until the participant coughed at baseline level, withdrew, or was discharged from hospital. Results: Sixty percent of participants had an absent cough reflex at CRT2 (x = 70 minutes). Participants varied in time to recovery of cough reflex. By CRT6, only 3 remaining participants persisted with an absent cough. Age, sex, or length of intubation had no significant impact on the time to recovery of cough reflex (P > .3). Conclusions: Absent cough reflex persists after CABG and may impact patients' ability to clear their airway in the event of aspiration. These results could contribute to better understanding postextubation dysphagia. More research is needed to determine if cough reflex is affected in the wider intensive care unit population postextubation and if CRT is a valid tool for detecting silent aspiration in this population. (C) 2015 Elsevier Inc. All rights reserved.