SESSION TITLE: Respiratory Care Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Inherent risk of endotracheal tube extubation is laryngeal edema. If clinically significant, it may lead to extubation failure, reintubation, and subsequent multitude of other complications. Laryngeal edema being a consequence of extubation, a predictive diagnostic test utilization is critically important. Non-invasive test such as cuff leak test (CLT) and laryngeal ultrasonography (LUS) have been employed. In this study, we aimed to determine the cutoff value of CLT and LUS in predicting clinically significant laryngeal edema applicable in intubated critical care patients of Lung Center of the Philippines. METHODS: A total of 80 mechanically ventilated adult patients in critical care units, wards, and recovery room, evaluated ready for extubation were tested using CLT and LUS prior to endotracheal tube liberation. Patients were observed within 24 hours for post extubation stridor, wheezing, desaturations, and respiratory distress as clinical significant symptoms of laryngeal edema. RESULTS: Of the 80 intubated patients evaluated, clinically significant laryngeal edema was present in 12.5% of patients. Of the 10 patients noted with clinically significant laryngeal edema 3.8% were observed to developed post extubation stridor. Accuracy of the cuff leak test and the laryngeal ultrasound was 96.1% and 86.2%, respectively. The optimal cutoff value for cuff leak volume was 13% with sensitivity and specificity of 100% and 91.4%, respectively. The optimal cutoff value for air column width difference was 33 mm with sensitivity and specificity were 100% and 70%, respectively. Negative predictive value were 100% for both test. Positive predictive values for CLT and LUS were 62.5% and 32.%, respectively. CONCLUSIONS: Both CLT and LUS showed high accuracy rate in predicting post extubation clinically significant laryngeal edema, being CLT higher than LUS. Both test showed high sensitivity, specificity, and negative predictive value. However, positive predictive values for both test were significantly low. CLINICAL IMPLICATIONS: Use of cuff leak test and laryngeal ultrasound may be integrated as part of institutional extubation protocol. DISCLOSURES: no disclosure on file for Maria Charisma Laborte; No relevant relationships by Portia Maria Tanyag, source=Web Response