title: Intra-individual variation of the cuff-leak test as a predictor of post-extubation stridor.
abstract: BACKGROUND
  This was an evaluation of intra-individual variation of the cuff-leak test (ΔCLT) immediately post-intubation and pre-extubation, as a predictor of post-extubation stridor.
  
  
  METHODS
  Prospective, clinical investigation in the ICU of a non-university hospital. CLTs were performed immediately after intubation (T0) and before extubation (T1) to evaluate the differences in cuff leak (ΔCLT = CL(T1) - CL(T0)).
  
  
  RESULTS
  We included 104 mechanically ventilated subjects in the study over a 12-month period. The incidence of post-extubation stridor was 6.7%. Stridor was more common in females of short stature. ΔCLT was considered as significant when CL(T1) - CL(T0) was negative. The sensitivity and the specificity of the test were 86% and 48%, respectively. When we tested the pre-extubation CLT alone with a threshold of 130 mL as a predictor of post-extubation stridor, the sensitivity and the specificity of the test were 86% and 76%, respectively.
  
  
  CONCLUSIONS
  The intra-individual variation of CLT immediately post-intubation and pre-extubation does not improve the accuracy of a standard pre-extubation CLT to predict post-extubation stridor. Moreover, the standard pre-extubation CLT did not appear in our study to be an ideal test to detect post-extubation stridor. Larger studies should be performed before generalizing these preliminary results.
authors.affiliation: René Dubos Hospital, Pontoise, France. antoinegros6@gmail.com
authors.forename: Antoine
authors.initials: A
authors.lastname: Gros
authors.forename: Laurent
authors.initials: L
authors.lastname: Holzapfel
authors.forename: Sophie
authors.initials: S
authors.lastname: Marqué
authors.forename: Laurent
authors.initials: L
authors.lastname: Perard
authors.forename: Guy
authors.initials: G
authors.lastname: Demingeon
authors.forename: Bonavie
authors.initials: B
authors.lastname: Piralla
authors.forename: Sandrine
authors.initials: S
authors.lastname: Gaillard
authors.forename: Xavier
authors.initials: X
authors.lastname: Tchenio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060666:Airway Extubation / Q000295:instrumentation; D005260:Female; D006801:Humans; D007819:Laryngeal Edema / Q000150:complications / Q000517:prevention & control; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000175:diagnosis* / Q000209:etiology; D012680:Sensitivity and Specificity