toux au cours du sevrage ventilatoire

Abstract

Cough is a vital physiological reflex that clears the tracheobronchial tree and facilitates effective gas exchange. In the intensive care setting, cough dysfunction is frequent, primarily due to respiratory muscle impairment and the presence of the endotracheal tube, which prevents glottic closure. This dysfunction has been identified as an independent risk factor for extubation failure and prolonged mechanical ventilation. Current guidelines recognize an effective cough as a key criterion for successful weaning from mechanical ventilation. Nevertheless, its clinical assessment remains challenging and lacks standardization. This review aims to detail the physiological mechanisms underlying the cough reflex, outline the pathophysiological alterations observed in critically ill patients, particularly during the weaning process, and examine the available methods for quantifying cough. Accurate and objective evaluation of cough function may improve the identification of patients at high risk of extubation failure and support the development of targeted strategies to optimize respiratory outcomes.