The cuff leak test to predict failure of tracheal extubation for laryngeal edema
Laryngeal edema secondary to endotracheal intubation may require early re-intubation. Prior to extubation the absence of leak around an endotracheal tube may predict laryngeal edema after extubation. We evaluated the usefulness of a quantitative assessment of such a leak to identify the patients who...
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| Veröffentlicht in: | Intensive care medicine 2002-09, Vol.28 (9), p.1267-1272 |
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| creator | DE BAST, Yann DE BACKER, Daniel MORAINE, Jean-Jacques LEMAIRE, Muriel VANDENBORGHT, Cécile VINCENT, Jean-Louis |
| description | Laryngeal edema secondary to endotracheal intubation may require early re-intubation. Prior to extubation the absence of leak around an endotracheal tube may predict laryngeal edema after extubation. We evaluated the usefulness of a quantitative assessment of such a leak to identify the patients who will require early re-intubation for laryngeal edema.
This prospective study included 76 patients with endotracheal intubation for more than 12 h. The leak, in percent, was defined as the difference between expired tidal volume measured just before extubation, in volume-controlled mode, with the cuff inflated and then deflated. The best cut-off value to predict the need for re-intubation for significant laryngeal edema was determined and the patients were divided into two groups, according to this cut-off value.
Eight of the 76 patients (11%) needed re-intubation for laryngeal edema. Patients requiring re-intubation had a smaller leak than the other patients [9 (3-18) vs 35 (13-53)%, p |
| doi_str_mv | 10.1007/s00134-002-1422-3 |
| format | Article |
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This prospective study included 76 patients with endotracheal intubation for more than 12 h. The leak, in percent, was defined as the difference between expired tidal volume measured just before extubation, in volume-controlled mode, with the cuff inflated and then deflated. The best cut-off value to predict the need for re-intubation for significant laryngeal edema was determined and the patients were divided into two groups, according to this cut-off value.
Eight of the 76 patients (11%) needed re-intubation for laryngeal edema. Patients requiring re-intubation had a smaller leak than the other patients [9 (3-18) vs 35 (13-53)%, p<0.01]. The best cut-off value for gas leak was 15.5%. The high leak group included 51 patients, of whom only two patients (3%) required re-intubation. The low leak group included 25 patients, among whom six patients (24%) required re-intubation ( p<0.01). The sensitivity of this test was 75%, the specificity 72.1%, the positive predictive value 25%, the negative predictive value 96.1% and the percent of correct classification 72.4%.
A gas leak around the endotracheal tube greater than 15.5% can be used as a screening test to limit the risk of re-intubation for laryngeal edema.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-002-1422-3</identifier><identifier>PMID: 12209275</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Belgium ; Biological and medical sciences ; Emergency and intensive respiratory care ; Humans ; Intensive care medicine ; Intubation, Intratracheal - adverse effects ; Laryngeal Edema - physiopathology ; Laryngeal Edema - therapy ; Medical sciences ; Middle Aged ; Prospective Studies ; Respiration, Artificial - adverse effects ; Sensitivity and Specificity ; Tidal Volume</subject><ispartof>Intensive care medicine, 2002-09, Vol.28 (9), p.1267-1272</ispartof><rights>2002 INIST-CNRS</rights><rights>Springer-Verlag 2002</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-b6cb9a6f4600bc77bd66dfadaf66cedf06429aa1c6aa86fa565733e054615f223</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13919731$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12209275$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DE BAST, Yann</creatorcontrib><creatorcontrib>DE BACKER, Daniel</creatorcontrib><creatorcontrib>MORAINE, Jean-Jacques</creatorcontrib><creatorcontrib>LEMAIRE, Muriel</creatorcontrib><creatorcontrib>VANDENBORGHT, Cécile</creatorcontrib><creatorcontrib>VINCENT, Jean-Louis</creatorcontrib><title>The cuff leak test to predict failure of tracheal extubation for laryngeal edema</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><description>Laryngeal edema secondary to endotracheal intubation may require early re-intubation. Prior to extubation the absence of leak around an endotracheal tube may predict laryngeal edema after extubation. We evaluated the usefulness of a quantitative assessment of such a leak to identify the patients who will require early re-intubation for laryngeal edema.
This prospective study included 76 patients with endotracheal intubation for more than 12 h. The leak, in percent, was defined as the difference between expired tidal volume measured just before extubation, in volume-controlled mode, with the cuff inflated and then deflated. The best cut-off value to predict the need for re-intubation for significant laryngeal edema was determined and the patients were divided into two groups, according to this cut-off value.
Eight of the 76 patients (11%) needed re-intubation for laryngeal edema. Patients requiring re-intubation had a smaller leak than the other patients [9 (3-18) vs 35 (13-53)%, p<0.01]. The best cut-off value for gas leak was 15.5%. The high leak group included 51 patients, of whom only two patients (3%) required re-intubation. The low leak group included 25 patients, among whom six patients (24%) required re-intubation ( p<0.01). The sensitivity of this test was 75%, the specificity 72.1%, the positive predictive value 25%, the negative predictive value 96.1% and the percent of correct classification 72.4%.
A gas leak around the endotracheal tube greater than 15.5% can be used as a screening test to limit the risk of re-intubation for laryngeal edema.</description><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Belgium</subject><subject>Biological and medical sciences</subject><subject>Emergency and intensive respiratory care</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Intubation, Intratracheal - adverse effects</subject><subject>Laryngeal Edema - physiopathology</subject><subject>Laryngeal Edema - therapy</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Respiration, Artificial - adverse effects</subject><subject>Sensitivity and Specificity</subject><subject>Tidal Volume</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkE1LAzEQhoMotlZ_gBcJgt5W853uUYpfUNBDPYfZbGK37kdNdkH_valdEDwNwzwzvPMgdE7JDSVE30ZCKBcZISyjgrGMH6ApFTx1jM8P0ZRwwTKhBJugkxg3idZK0mM0oYyRnGk5Ra-rtcN28B7XDj5w72KP-w5vgysr22MPVT0EhzuP-wB27aDG7qsfCuirrsW-C7iG8N2-_w5K18ApOvJQR3c21hl6e7hfLZ6y5cvj8-JumVmheJ8VyhY5KC8UIYXVuiiVKj2U4JWyrvQkpc4BqFUAc-VBKqk5d0QKRaVnjM_Q9f7uNnSfQ4ptmipaV9fQum6IRjMipUw2ZujyH7jphtCmbIZRxSiVep4guods6GIMzpttqJr0maHE7FybvWuTXJuda8PTzsV4eCgaV_5tjHITcDUCEC3UPkBrq_jH8ZzmmlP-A0s0hiQ</recordid><startdate>20020901</startdate><enddate>20020901</enddate><creator>DE BAST, Yann</creator><creator>DE BACKER, Daniel</creator><creator>MORAINE, Jean-Jacques</creator><creator>LEMAIRE, Muriel</creator><creator>VANDENBORGHT, Cécile</creator><creator>VINCENT, Jean-Louis</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20020901</creationdate><title>The cuff leak test to predict failure of tracheal extubation for laryngeal edema</title><author>DE BAST, Yann ; DE BACKER, Daniel ; MORAINE, Jean-Jacques ; LEMAIRE, Muriel ; VANDENBORGHT, Cécile ; VINCENT, Jean-Louis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-b6cb9a6f4600bc77bd66dfadaf66cedf06429aa1c6aa86fa565733e054615f223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Belgium</topic><topic>Biological and medical sciences</topic><topic>Emergency and intensive respiratory care</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Intubation, Intratracheal - adverse effects</topic><topic>Laryngeal Edema - physiopathology</topic><topic>Laryngeal Edema - therapy</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Respiration, Artificial - adverse effects</topic><topic>Sensitivity and Specificity</topic><topic>Tidal Volume</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DE BAST, Yann</creatorcontrib><creatorcontrib>DE BACKER, Daniel</creatorcontrib><creatorcontrib>MORAINE, Jean-Jacques</creatorcontrib><creatorcontrib>LEMAIRE, Muriel</creatorcontrib><creatorcontrib>VANDENBORGHT, Cécile</creatorcontrib><creatorcontrib>VINCENT, Jean-Louis</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DE BAST, Yann</au><au>DE BACKER, Daniel</au><au>MORAINE, Jean-Jacques</au><au>LEMAIRE, Muriel</au><au>VANDENBORGHT, Cécile</au><au>VINCENT, Jean-Louis</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The cuff leak test to predict failure of tracheal extubation for laryngeal edema</atitle><jtitle>Intensive care medicine</jtitle><addtitle>Intensive Care Med</addtitle><date>2002-09-01</date><risdate>2002</risdate><volume>28</volume><issue>9</issue><spage>1267</spage><epage>1272</epage><pages>1267-1272</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>Laryngeal edema secondary to endotracheal intubation may require early re-intubation. Prior to extubation the absence of leak around an endotracheal tube may predict laryngeal edema after extubation. We evaluated the usefulness of a quantitative assessment of such a leak to identify the patients who will require early re-intubation for laryngeal edema.
This prospective study included 76 patients with endotracheal intubation for more than 12 h. The leak, in percent, was defined as the difference between expired tidal volume measured just before extubation, in volume-controlled mode, with the cuff inflated and then deflated. The best cut-off value to predict the need for re-intubation for significant laryngeal edema was determined and the patients were divided into two groups, according to this cut-off value.
Eight of the 76 patients (11%) needed re-intubation for laryngeal edema. Patients requiring re-intubation had a smaller leak than the other patients [9 (3-18) vs 35 (13-53)%, p<0.01]. The best cut-off value for gas leak was 15.5%. The high leak group included 51 patients, of whom only two patients (3%) required re-intubation. The low leak group included 25 patients, among whom six patients (24%) required re-intubation ( p<0.01). The sensitivity of this test was 75%, the specificity 72.1%, the positive predictive value 25%, the negative predictive value 96.1% and the percent of correct classification 72.4%.
A gas leak around the endotracheal tube greater than 15.5% can be used as a screening test to limit the risk of re-intubation for laryngeal edema.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>12209275</pmid><doi>10.1007/s00134-002-1422-3</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Belgium Biological and medical sciences Emergency and intensive respiratory care Humans Intensive care medicine Intubation, Intratracheal - adverse effects Laryngeal Edema - physiopathology Laryngeal Edema - therapy Medical sciences Middle Aged Prospective Studies Respiration, Artificial - adverse effects Sensitivity and Specificity Tidal Volume |
| title | The cuff leak test to predict failure of tracheal extubation for laryngeal edema |
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