The Cuff Leak Test In Critically Ill Patients: An International Survey of Intensivists

2021 ◽  
Author(s):  
Kimberley Lewis ◽  
Yousef Almubarak ◽  
Morten Hylander Møller ◽  
Roman Jaeschke ◽  
Dan Perri ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
International Survey ◽  
Leak Test ◽  
Cuff Leak

scholarly journals Predictors of post-extubation stridor in patients on mechanical ventilation: a prospective observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aiko Tanaka ◽  
Akinori Uchiyama ◽  
Yu Horiguchi ◽  
Ryota Higeno ◽  
Ryota Sakaguchi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Spontaneous Breathing Trial ◽  
Leak Test ◽  
Endotracheal Suctioning ◽  
Cuff Leak ◽  
The Impact

AbstractThe cuff leak test (CLT) has been widely accepted as a simple and noninvasive method for predicting post-extubation stridor (PES). However, its accuracy and clinical impact remain uncertain. We aimed to evaluate the reliability of CLT and to assess the impact of pre-extubation variables on the incidence of PES. A prospective observational study was performed on adult critically ill patients who required mechanical ventilation for more than 24 h. Patients were extubated after the successful spontaneous breathing trial, and CLT was conducted before extubation. Of the 191 patients studied, 26 (13.6%) were deemed positive through CLT. PES developed in 19 patients (9.9%) and resulted in a higher reintubation rate (8.1% vs. 52.6%, p < 0.001) and longer intensive care unit stay (8 [4.5–14] vs. 12 [8–30.5] days, p = 0.01) than patients without PES. The incidence of PES and post-extubation outcomes were similar in patients with both positive and negative CLT results. Compared with patients without PES, patients with PES had longer durations of endotracheal intubation and required endotracheal suctioning more frequently during the 24-h period prior to extubation. After adjusting for confounding factors, frequent endotracheal suctioning more than 15 times per day was associated with an adjusted odds ratio of 2.97 (95% confidence interval, 1.01–8.77) for PES. In conclusion, frequent endotracheal suctioning before extubation was a significant PES predictor in critically ill patients. Further investigations of its impact on the incidence of PES and patient outcomes are warranted.

Cuff Leak Test for the Diagnosis of Post-Extubation Stridor: A Multicenter Evaluation Study

2017 ◽  
Vol 34 (5) ◽  
pp. 391-396 ◽  
Author(s):  
David Schnell ◽  
Benjamin Planquette ◽  
Asaël Berger ◽  
Sybille Merceron ◽  
Julien Mayaux ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Diagnostic Performance ◽  
Prolonged Mechanical Ventilation ◽  
Evaluation Study ◽  
High Rate ◽  
Leak Test ◽  
Predictive Values ◽  
Cuff Leak ◽  
Multicenter Prospective Study

Background: Cuff leak test was developed to predict the occurrence of post-extubation stridor (PES). This study evaluated the diagnostic performance of this test in unselected critically ill patients. Methods: Multicenter prospective study including unselected ventilated patients at the time of their first planned extubation. The diagnostic performance of 4 different cuff leak tests was assessed. Results: Post-extubation stridor occurred in 34 (9.4%) of 362 included patients. Compared to patients without PES, patients with PES required more frequently reintubation (6 [17.6%] vs 26 [7.9%], P = .041), prolonged duration of ventilation (6 [3-13] vs 5 [2-9] days, P = .029), and longer intensive care unit (ICU) stay (12 [6-17.5] vs 7.5 [4-13] days, P = .018). However, ICU mortality was similar in both groups (1 [2.9%] vs 23 [7.0%], P = .61). The 4 cuff leak tests display poor diagnostic accuracy: sensitivities ranging from 27% to 46%, specificities from 70% to 88%, positive predictive values from 14% to 19%, and negative predictive values from 92% to 93%. Conclusion: Post-extubation stridor occurs in less than 10% of unselected critically ill patients. The several cuff leak tests display limited diagnostic performance for the detection of PES. Given the high rate of false positives, routine cuff leak test may expose to undue prolonged mechanical ventilation.

International Survey on Determinants of Antibiotic Duration and Discontinuation in Pediatric Critically Ill Patients

2020 ◽  
Vol 21 (9) ◽  
pp. e696-e706 ◽  
Author(s):  
Kim C. Noël ◽  
Jesse Papenburg ◽  
Jacques Lacroix ◽  
Caroline Quach ◽  
Shauna O’Donnell ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
International Survey ◽  
Antibiotic Duration

scholarly journals International Survey on the Management of Acute Kidney Injury in Critically Ill Patients: Year 2007

2010 ◽  
Vol 30 (3) ◽  
pp. 214-220 ◽  
Author(s):  
Flavio Basso ◽  
Zaccaria Ricci ◽  
Dinna Cruz ◽  
Claudio Ronco
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
International Survey

Preferred plasma volume expanders for critically ill patients: results of an international survey

2004 ◽  
Vol 30 (12) ◽  
pp. 2222-2229 ◽  
Author(s):  
Fr�d�rique Schortgen ◽  
Nicolas Deye ◽  
Laurent Brochard ◽  
Keyword(s):  
Critically Ill ◽  
Plasma Volume ◽  
Critically Ill Patients ◽  
International Survey

Management of severe acute renal failure in critically ill patients: an international survey in 345 centres

2001 ◽  
Vol 16 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Claudio Ronco ◽  
Monica Zanella ◽  
Alessandra Brendolan ◽  
Massimo Milan ◽  
Giovanna Canato ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
International Survey

scholarly journals Corticosteroids for critically ill patients: an international survey of intensivists

Critical Care ◽  
2012 ◽  
Vol 16 (S1) ◽  
Author(s):  
F Lamontagne ◽  
N Adhikari ◽  
D Cook ◽  
KK Koo ◽  
F Lauzier ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
International Survey
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