scholarly journals OPTIMAL CUTOFF VALUES IN IMPROVING ACCURACY OF CUFF LEAK TEST AND LARYNGEAL ULTRASONOGRAPHY IN PREDICTING POST EXTUBATION CLINICALLY SIGNIFICANT LARYNGEAL EDEMA IN CRITICAL CARE PATIENTS

CHEST Journal ◽  
2020 ◽  
Vol 157 (6) ◽  
pp. A115
Author(s):  
P.M. Tanyag ◽  
M.C. Laborte
Keyword(s):  
Critical Care ◽  
Laryngeal Edema ◽  
Leak Test ◽  
Optimal Cutoff ◽  
Cutoff Values ◽  
Cuff Leak ◽  
Clinically Significant ◽  
Improving Accuracy ◽  
Critical Care Patients ◽  
Laryngeal Ultrasonography

scholarly journals Comparison between Cuff Leak Test and Ultra Sound Assessment of Laryngeal Edema in Predicting Successful Extubation in Mechanically Ventilated Patients

2020 ◽  
pp. 43-51
Author(s):  
Manar Mohammed Ismail ◽  
Sohair Mostafa Soliman ◽  
Hoda Alsaid Ahmed Ezz ◽  
Amr Arafa Elbadry
Keyword(s):  
Endotracheal Intubation ◽  
Ultra Sound ◽  
Laryngeal Edema ◽  
Leak Test ◽  
Vocal Cords ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Cuff Leak ◽  
Ventilated Patients ◽  
Successful Extubation

Objects: Endotracheal intubation commonly leads to local complications, including mechanical lesions, such as friction and compressions between the tube and the anatomic structures of the larynx leading to laryngeal edemamanifested as ‘‘stridor’’ after extubation. There is no standard method to predict patients at risk of post-extubation stridor. This study was conducted to compare between cuff leak test and ultra sound in predicting successful extubation in mechanically ventilated patients. Patients and Methods: We included a total of 83 mechanically ventilated patients with endotracheal intubation > 24 hours. They were divided according to the outcome after extubation into 72 patients who didn’t develop laryngeal edema and 11 patients who developed laryngeal edema. The patients were extubated when they fulfilled the criteria of extubation and become negative to cuff leak test. All patients underwent both cuff leak test (CLT) and ultra-sound to assess air column width difference (ACWD) after intubation and before extubation. Results: All patients were matched as regard demographic data. There was a significant increase in the duration of mechanical ventilation in the LE group. No significant difference was detected between the two groups regarding CLT and ACWD after intubation. However, cases with laryngeal edema had significantly lower CLT and ACWD before extubation. Using a cut off value of 1.52 mm, ACWD had sensitivity and specificity of 90.9 and 91.7% respectively to predict laryngeal edema after extubation. Conclusions: Laryngeal Ultrasonography could be a useful, reliable, non-invasive method in the evaluation of vocal cords, laryngeal morphology and airflow passing through the vocal cords or subglottic area in intubated patients in comparison with cuff leak test.

The cuff leak test to predict failure of tracheal extubation for laryngeal edema

2002 ◽  
Vol 28 (9) ◽  
pp. 1267-1272 ◽  
Author(s):  
Yann De Bast ◽  
Daniel De Backer ◽  
Jean-Jacques Moraine ◽  
Muriel Lemaire ◽  
Cécile Vandenborght ◽  
...  
Keyword(s):  
Tracheal Extubation ◽  
Laryngeal Edema ◽  
Leak Test ◽  
Cuff Leak

scholarly journals An Extubation Protocol for Angioedema

OTO Open ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 2473974X1769123
Author(s):  
Elizabeth Floyd ◽  
Nira A. Goldstein ◽  
Rauno Joks ◽  
Miguel Mascaro ◽  
Christine Liaw ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Direct Laryngoscopy ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Laryngeal Edema ◽  
Fiberoptic Intubation ◽  
Endotracheal Tube Cuff ◽  
Leak Test ◽  
Converting Enzyme Inhibitors ◽  
Tube Cuff ◽  
Cuff Leak

Angioedema—nonpitting edema of the mucous membranes and skin—most commonly occurs as a complication from the use of angiotensin-converting enzyme inhibitors. At our institution, the otolaryngology department has incorporated the use of the endotracheal tube cuff-leak test and bedside direct laryngoscopy to aid in timing for extubation of angioedema patients. Prospective data collection of patients presenting to the emergency department with angioedema was performed. Of 76 patients with angioedema, 9 required fiberoptic intubation. Intubation was performed at a median of 73 hours (range, 44-118). An endotracheal tube cuff-leak test was performed in 7 patients prior to extubation, and bedside direct laryngoscopy was also performed in 3 of these 7 patients to document resolution of laryngeal edema. The use of the endotracheal tube cuff-leak test and bedside direct laryngoscopy is an easy and inexpensive method to help determine eligibility for extubation in patients intubated for angioedema.

PREDICTING LARYNGEAL EDEMA AND STRIDOR UTILIZING CUFF LEAK TEST VS LARYNGEAL AIR COLUMN WIDTH DIFFERENCE: SYSTEMATIC REVIEW AND META-ANALYSIS

CHEST Journal ◽  
2018 ◽  
Vol 154 (4) ◽  
pp. 368A
Author(s):  
TAMER SAID AHMED ◽  
ZUBAIR KHAN ◽  
KHALED SROUR ◽  
ALI ELTATAWY ◽  
MUJAHED ALKHATHLAN ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Laryngeal Edema ◽  
Leak Test ◽  
Width Difference ◽  
Cuff Leak ◽  
Air Column

scholarly journals A Case of Laryngeal Edema Induced after Extubation in Spite of Negative Cuff-Leak Test

2021 ◽  
Vol 41 (3) ◽  
pp. 232-234
Author(s):  
Akira INOUE ◽  
Kunio KANAO ◽  
Kiyotsugu TAKUMA
Keyword(s):  
Laryngeal Edema ◽  
Leak Test ◽  
Cuff Leak

scholarly journals The Role of laryngeal ultrasound in comparison with cuff leak test in prediction of post extubation stridor

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S W Nashed ◽  
N M Elsharnouby ◽  
M A Abdulnaiem ◽  
S M Eltaher
Keyword(s):  
Airway Obstruction ◽  
Cuff Pressure ◽  
Prolonged Mechanical Ventilation ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Leak Test ◽  
Prolonged Intubation ◽  
Cuff Leak ◽  
Air Column ◽  
Laryngeal Ultrasonography

Abstract Background Endotracheal intubation is commonly used in (ICU) for different causes. However, intubation/extubation may lead to the development of complications such as post-extubation stridor (PES), one of the most frequent causes of reintubation, prolonged mechanical ventilation, and increased morbidity in the ICU patients. PES and upper-airway obstruction are multifactorial in etiology and can occur as a result of laryngotracheal edema, intubation trauma, excessive cuff pressure with mucosal ulceration, and prolonged intubation with secondary inflammation and granuloma formation. Objective: The aim of this study was to evaluate the value of laryngeal ultrasonography versus cuff leak test in predicting post-extubation stridor. Patients and Methods Our study included fifty patients admitted to the critical care department, Misr University for Science and Technology Hospitals from the period of November 2017 to July 2018 intubated for different causes for a minimum of 24 h. excluded patients primarily intubated for the upper airway obstruction, patients with laryngeal carcinoma, Previous tracheostomy, neck radiotherapy. All patients will undergo for laryngeal ultrasonography versus cuff leak test to predict post-extubation stridor. Results In our study CLT identified PES patients with a sensitivity of 75%. But with low PPV of 50% for leakage volume of (132.5 mm ) . Laryngeal ultrasound showed a sensitivity of 50% for those patients with air column width before deflation less than 10.955 mm and ACWD 0.905 mm with PPV of 11.8% and 14.3% for air column width and ACWD respectively Conclusion Both CLT (Cuff leak test) and laryngeal US (ultrasound) might have sensitivity in predicting PES and should be used with caution in this regard.

Sign in / Sign up

Export Citation Format

Share Document