Peak cough flow and diaphragmatic excursion during coughing in stroke patients with tracheostomy: a cross-sectional study.

BACKGROUND

Although peak cough flow (PCF) is a critical indicator for tracheostomized stroke patients, it remains unclear whether diaphragmatic excursion during reflex cough, as the primary driver of inspiration, can predict PCF.

OBJECTIVE

To explore whether the diaphragmatic excursion during reflex coughing can predict PCF in stroke patients with tracheostomy.

METHODS

A total of 57 stroke patients were included in the study. The diaphragm excursion and PCF were measured and a simple linear regression was used to analyze the relationship between them. T-test, Chi-square test and Mann-Whitney U test were used to analyze the influencing factors of PCF, and multiple linear regression was used to construct a regression model.

RESULTS

A simple regression model showed significant associations between diaphragmatic excursion and PCF in patients with unilateral and bilateral paralysis (p = 0.036, R = 0.372, R2 = 0.139 for patients with unilateral paralysis; p = 0.002, R = 0.592, R2 = 0.350 for patients with bilateral paralysis). Except for the diaphragmatic excursion, the type of paresis was also an influencing factor for PCF. A multiple regression model adjusted for type of paresis showed a significant association between PCF and diaphragmatic excursion (p < 0.001, adjusted regression coefficient = 7.883, adjusted R2 = 0.257).

CONCLUSIONS

Diaphragmatic excursion during coughing was correlated with PCF. Furthermore, the type of paresis in stroke patients was identified as a significant factor affecting PCF. Our study established the preliminary diaphragmatic excursion-adjusted type of paresis equation as a predictor for estimating PCF in patients with stroke who underwent tracheostomy.

TRIAL REGISTRATION NUMBERS: ChiCTR2200063174.