Laryngeal ultrasound versus cuff leak test in prediction of post-extubation stridor

IF 0.3 Q4 CRITICAL CARE MEDICINE Egyptian Journal of Critical Care Medicine Pub Date : 2017-12-01 DOI:10.1016/j.ejccm.2017.10.002
Mai A. Sahbal, Kamel A. Mohamed, Hanan H. Zaghla, Mahmoud M. Kenawy
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引用次数: 8

Abstract

Background

Cuff leak test (CLT) has been proposed as a simple method of predicting post-extubation stridor (PES), however due to different cut-off point of cuff-leak volume between previous studies, the laryngeal ultrasonography (US) including measurement of air column width was used to predict PES. The aim of the present study was to evaluate the value of laryngeal US versus cuff leak test in predicting PES.

Methods

The study included fifty patients admitted to the Critical Care Department, Cairo University Hospitals from the period of November 2014 to January 2016, intubated for at least 24 h and examined prior to extubation using CLT and laryngeal ultrasound.

Results

Four cases developed PES. CLT identified PES patients with a sensitivity of 75%, with PPV of 50% for leakage volume of 132.5 ml. Laryngeal ultrasound showed a sensitivity of 50% for those patients with air column width before deflation less than 10.955 mm and air column width difference (ACWD) of 0.905 mm with PPV of 11.8% and 14.3% for both respectively.

Conclusion

Both CLT and laryngeal US might have low sensitivity and PPV in predicting PES and should be used with caution in prediction of PES.

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喉超声与袖带泄漏试验预测拔管后喘鸣
摘要袖带泄漏试验(CLT)被认为是预测拔管后喘鸣(PES)的一种简单方法,但由于以往研究中袖带泄漏量的截止点不同,因此采用喉超声(US)包括测量气柱宽度来预测PES。本研究的目的是评估喉超声与喉套泄漏试验在预测PES中的价值。方法选取2014年11月至2016年1月在开罗大学附属医院重症监护科收治的50例患者,插管时间至少24 h,拔管前采用CLT和喉部超声检查。结果4例发生PES。CLT识别PES患者的敏感性为75%,漏气量为132.5 ml时PPV为50%。气管收缩前气柱宽度小于10.955 mm、气柱宽度差(ACWD)为0.905 mm的患者喉部超声灵敏度为50%,PPV分别为11.8%和14.3%。结论CLT和喉部超声对PES的预测敏感性和PPV均较低,在预测PES时应谨慎使用。
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来源期刊
自引率
0.00%
发文量
5
审稿时长
42 weeks
期刊介绍: The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.
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