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(Chest. 1999;116:1029-1031.)
© 1999 American College of Chest Physicians

Evaluation of the Cuff-Leak Test in a Cardiac Surgery Population*

Milo Engoren, MD, FCCP

* From the Departments of Anesthesiology and Internal Medicine, St. Vincent Mercy Medical Center, Cherry, OH.

Correspondence to: Milo Engoren, MD, FCCP, Departments of Anesthesiology and Internal Medicine, St. Vincent Mercy Medical Center, 2213 Cherry St, Toledo, OH 43608; e-mail: engoren{at}pol.net

Objective: The purpose of this study is to determine the accuracy of the cuff-leak test in a cardiovascular ICU.

Methods: Five hundred twenty-four patients were tested immediately before being extubated 531 times. The cuff-leak test was performed with the ventilator set in assist-control mode at a tidal volume (VT) of 10 to 12 mL/kg. The leak was taken to be the difference between the preset inspiratory VT and the average of the three lowest of the subsequent six expiratory VTs. A leak <= 110 mL was considered to be a positive leak test.

Results: None of the 20 patients with a positive leak test developed problems. Three patients had postextubation stridor. Their leaks were 433, 312, and 350 mL.

Conclusion: The cuff-leak test is inaccurate and cannot be recommended for routine use in this population.

Key Words: airway obstruction • cuff-leak test • extubation failure • laryngeal edema • mechanical ventilation • stridor




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