Cough Impairment and Risk of Postoperative Pulmonary Complications After Open Upper Abdominal Surgery

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dc.contributor.authorBonfim Colucci, Daniela B. [UNIFESP]
dc.contributor.authorFiore, Julio F.
dc.contributor.authorPaisani, Denise M.
dc.contributor.authorRisso, Thais Telles
dc.contributor.authorColucci, Marcelo
dc.contributor.authorChiavegato, Luciana Dias
dc.contributor.authorFaresin, Sonia Maria [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionMcGill Univ
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniv Ctr Vila Velha
dc.contributor.institutionNove de Julho Univ
dc.contributor.institutionUniv City São Paulo UNICID
dc.date.accessioned2016-01-24T14:40:30Z
dc.date.available2016-01-24T14:40:30Z
dc.date.issued2015-05-01
dc.description.abstractBACKGROUND: Cough impairment is often described as part of the pathophysiological basis of postoperative pulmonary complications (PPCs). However, there have been few studies examining cough effectiveness and its relationship with PPCs following open upper abdominal surgery. the goal of this study was to estimate (1) changes in cough efficacy after upper abdominal surgery through the assessment of peak cough flow and (2) the extent to which cough impairment is associated with postoperative pain, FVC, and risk of PPCs. METHODS: This prospective cohort study assessed 101 subjects (45% male, 56 +/- 16 y old) admitted for elective upper abdominal surgery. Measurements of peak cough flow and FVC were performed on the day before surgery and repeated on postoperative days 1, 3, and 5. PPCs were assessed daily by a pulmonologist blinded to the cough measurement results. RESULTS: Peak cough flow dropped to 54% of the preoperative value on postoperative day 1 and gradually increased on postoperative days 3 (65%) and 5 (72%) (P < .05). On all postoperative days, peak cough flow was strongly correlated with FVC (P < .001) and weakly correlated with pain (P = .006). Six subjects (6%) developed PPCs. the association between peak cough flow and risk of PPCs was not statistically significant (unadjusted odds ratio of 0.80, 95% CI 0.45-1.40, P = .44; adjusted odds ratio of 0.66, 95% CI 0.32-1.38, P = .41). CONCLUSIONS: Cough effectiveness is impaired after upper abdominal surgery. Postoperative restrictive lung dysfunction seems to be associated with this impairment. There is no significant association between peak cough flow and PPCs; however, cough impairment might result in clinically important consequences in a high-risk population. (C) 2015 Daedalus Enterprisesen
dc.description.affiliationUniversidade Federal de São Paulo, Resp Dept, São Paulo, Brazil
dc.description.affiliationMcGill Univ, Ctr Hlth, Steinberg Bernstein Ctr Minimally Invas Surg & In, Montreal, PQ, Canada
dc.description.affiliationUniv São Paulo, Sch Med, Dept Phys Med, São Paulo, Brazil
dc.description.affiliationUniv Ctr Vila Velha, Phys Therapy Dept, Vila Velha, ES, Brazil
dc.description.affiliationNove de Julho Univ, Phys Therapy Dept, São Paulo, Brazil
dc.description.affiliationUniv City São Paulo UNICID, Masters & Doctoral Program, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Resp Dept, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
dc.format.extent673-678
dc.identifierhttp://dx.doi.org/10.4187/respcare.03600
dc.identifier.citationRespiratory Care. Irving: Daedalus Enterprises Inc, v. 60, n. 5, p. 673-678, 2015.
dc.identifier.doi10.4187/respcare.03600
dc.identifier.issn0020-1324
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/39096
dc.identifier.wosWOS:000354192100014
dc.language.isoeng
dc.publisherDaedalus Enterprises Inc
dc.relation.ispartofRespiratory Care
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectcoughen
dc.subjectrisk factorsen
dc.subjectsurgeryen
dc.subjectpostoperative complicationsen
dc.subjectpostoperative careen
dc.titleCough Impairment and Risk of Postoperative Pulmonary Complications After Open Upper Abdominal Surgeryen
dc.typeinfo:eu-repo/semantics/article
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