Cuff Leak Test Research Articles

Detection of a Tracheal Obstruction Caused by a Retrosternal Goiter by the Use of a Cuff Leak Test

Detection of a Tracheal Obstruction Caused by a Retrosternal Goiter by the Use of a Cuff Leak Test

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

The purpose of this study is to determine the accuracy of the cuff-leak test in a cardiovascular ICU. 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. 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. The cuff-leak test is inaccurate and cannot be recommended for routine use in this population.

The 'cuff-leak' test for extubation.

The 'cuff-leak' test, which involves demonstrating a leak around a tracheal tube with the cuff deflated, has been advocated to determine the safety of extubation in patients with upper airway obstruction. In 62 such patients we were able safely to extubate all patients with a cuff leak. Two patients extubated without cuff leak required reintubation and in five patients who repeatedly failed the test, tracheostomy was performed. Subsequently, we extubated 10 patients who were stable on spontaneous ventilation and did not have cuff leak; three later required tracheostomy and seven were uneventfully extubated. While the presence of cuff leak demonstrates that extubation is likely to be successful, a failed cuff-leak test does not preclude uneventful extubation and if used as a criterion for extubation may lead to unnecessarily prolonged intubation or to unnecessary tracheostomy.