The Journal of Thoracic and Cardiovascular Surgery, Vol 80, 600-604, Copyright © 1980 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Intrapleural cough pressure in patients after thoracotomy
S Yamazaki, J Ogawa, A Shohzu and Y Yamazaki
Quantitative studies of cough strength seem to be valuable in evaluating
cough dynamics and the effectiveness of various procedures designed to
raise the cough force. To evaluate cough strength in 20 patients after
thoracotomy intrapleural cough pressures were measured with a balloon
catheter inserted in the ipsilateral pleural space toward the apex. A
balloon catheter designed to measure intraluminal esophageal pressure was
used in this study. The balloon was inflated with 1 ml of air and the
transmitted intrapleural pressure was measured during the maximum voluntary
cough effort in the supine and/or sitting position. The pressure change
during coughing seems to serve as an index in evaluating the strength of
the respiratory muscles. It was observed that the cough pressure increased
progressively following thoracotomy, and that it was higher in the sitting
position than in the supine position. The most effective procedure to raise
the maximum cough pressure was manually assisted compression of the chest
wall in the sitting position during voluntary coughing. Epidural anesthesia
following thoracotomy seemed to be effective in inducing higher cough
pressure changes.
