Evaluation of the cuff-leak test in a cardiac surgery population.
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.


CONCLUSIONS
The cuff-leak test is inaccurate and cannot be recommended for routine use in this population.
Engoren
M
M
Departments of Anesthesiology and Internal Medicine, St. Vincent Mercy Medical Center, Cherry, OH, USA. engoren@pol.net
D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology; D006348:Cardiac Surgical Procedures; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011379:Prognosis; D013990:Tidal Volume / Q000502:physiology; D015300:Ventilator Weaning