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Abstract Background Cough pressure, an expression of expiratory muscle strength, is usually measured with esophageal or gastric balloons, but these invasive catheters can be uncomfortable for the patient or their placement impractical. Because pressure in the thorax and abdomen are expected to be similar during a cough, we hypothesized that measurement at other thoracic or abdominal locations might also be similar as well as useful in clinical scenarios. This study aimed to compare cough pressures measured at thoracic and abdominal sites that could serve as alternatives to esophageal pressures (P es ). Methods Nine patients scheduled for laparotomy were asked to cough as forcefully as possible from total lung capacity in supine position. Three cough maneuvers were performed while P es (the gold standard) as well as gastric, central venous, bladder and rectal pressures (P ga , P cv , P bl , and P rec , respectively) were measured simultaneously. The intraclass correlation coefficient (ICC) was used to evaluate the repeatability of the measurements in each patient at each site and evaluate agreement between alternative sites (P ga , P cv , P bl , and P rec ) and P es . Bland–Altman plots were used to compare Pes and the measurements at the other sites. Results Median (first quartile, third quartile) maximum pressures were as follows: P es 112 (89,148), P ga 105 (92,156), P cv 102 (91,149), P bl 118 (93,157), and P rec 103 (88,150) cmH2O. The ICCs showed excellent within-site repeatability of the measurements (p |
