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Evaluation of the cuff-leak test in a cardiac surgery population
1Departments of Anesthesiology and Internal Medicine, St. Vincent Mercy Medical Center, Cherry, OH, USA. engoren@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
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.