PT  - JOURNAL ARTICLE
AU  - Richard Turner
AU  - James Murray
AU  - Alice Repossi
AU  - Sheena Barnett
AU  - Gillian Tomlinson
AU  - Manoj Menon
AU  - Graham Bothamley
AU  - Angshu Bhowmik
TI  - Pre-existing cough predicts coughing during endobronchial ultrasound (EBUS)
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P3722
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P3722.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P3722.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Introduction Coughing hinders EBUS and aerosolises secretions. Predictors of cough in bronchoscopy and methods of quantifying it are poorly described.Method Successive patients wore an audio recorder and microphone immediately before, during and after EBUS. Each recording was analysed by one of three authors; half were re-analysed by the main author. Coughs were counted using audio editing software.Results A mean (±SE) of 5.61±1.11 coughs/min were counted during EBUS from 24 patients with cancer (n=13), sarcoid (n=7), tuberculosis (n=2) or reactive mediastinal lymphadenopathy (n=2). The mean disagreement between listeners was 17.8±6.1%. Cough counts were higher in the 12 patients reporting a pre-existing cough (Figure; p=0.05). Coughing during the median (range) 18 (10-100) minutes prior to EBUS was not associated with cough rates during the procedure. There was a trend towards increased cough in the 11 current smokers, as well as those with lung abnormalities on imaging and with cancer, but this was not statistically significant (p=0.30, 0.10 and 0.14, respectively). All received topical lidocaine. There was no evidence of cough suppression in the 17 and 15 patients given 50-100 mcg intravenous fentanyl or 1-4 mg midazolam, respectively.Conclusion Cough frequency in EBUS is highly variable and its measurement difficult although it is higher with pre-existing cough. The influence of medication and other variables remains unclear.