A Modified Cuff Leak Test and Reintubation in Mechanically Ventilated Patients

A Modified Cuff Leak Test and Reintubation in Mechanically Ventilated Patients: a Multicenter Randomised Controlled Trial

We hypothesized that the accuracy of the modified cuff leak test in predicting re-intubation in tracheal intubated patients is better than that of the conventional balloon leak test, thereby further reducing the re-intubation rate.

The cuff leak test is an effective method for predicting the occurrence of upper airway obstruction in patients with endotracheal intubation after extubation, with high specificity and moderate sensitivity. However, there is still no clear and unified cuff leak test operation specification. A cohort study has proposed a modified method. When the patient is placed in a semi-recumbent position of 60 degrees and the ventilator is set to a low-flow square wave, it is more predictive than conventional methods. We hypothesized that the accuracy of the modified cuff leak test in predicting re-intubation in tracheal intubated patients is better than that of the conventional balloon leak test, thereby further reducing the re-intubation rate.

The subject was placed in a semi-recumbent position. The subjects were placed in volume assist-control mode with the following parameters: respiratory rate 15 breaths/min original oxygen concentration PEEP 0 cm H2O the VT was set according to the subject's stable VT in the previous ventilator mode inspiratory flow was set at 30 L/min with square waveform Positive cutoff value of the air leak volume was 116 mL and the air leak ratio was 0.32.

The subjects were placed in volume assist-control mode with the following parameters: respiratory rate was adapted to patient comfort original oxygen concentration and PEEP the VT about 8ml/Kg IBW inspiratory flow was set at 60 L/min with square waveform Positive cutoff value of the air leak volume was 110 mL and the air leak ratio was 0.15.

Cuff leak test is a simple and convenient tool that can be used to predict upper-airway obstruction after extubation. The CLT is used to assess airway patency through listening for an air leak and observing changes in tidal volume (VT) after the cuff is deflated.

fulfilled predefined criteria indicating the need for reintubation within 48 hours following extubation

The incidence of fulfilled predefined criteria indicating the need for reintubation within 48 hours following extubation

Inclusion Criteria: Age ≥ 18 years old Oral endotracheal intubation and mechanical ventilation > 36 hours Fulfilled the weaning criteria Exclusion Criteria: The patient has a chest drainage tube and there is persistent air leak Abnormalities of the larynx: such as tumors or vocal cord paralysis The patient cannot maintain the semi-recumbent position Unconventional weaning, such as awake ECMO, etc Participated in the study during the hospitalization Patients or their relatives refused written informed consent