Using the Cuff-Leak Test to Predict Extubation Success or Failure

Despite their role as life-saving procedures, endotracheal intubation and mechanical ventilation can cause severe complications. A significant factor in extubation failure is laryngeal edema and airway obstruction after extubation.Its clinical symptom, post-extubation stridor, has a documented incidence of 2-26% and patients commonly require reintubation.1 The most used screening test for airway edema and post-extubation airway obstruction is a cuff-leak test (CLT), a test which includes deflating the endotracheal tube (ETT)balloon and listening for air flowing around the ETT. The positive cuff-leak test can, in a high percentage, predict post-extubation airway obstruction. However, due to its low to moderate sensitivity, a negative test cannot exclude potential complications after the patient has been extubated.In this article, we’ll discuss why and how the cuff-leak test should be used to predict post-extubation stridor, as well as extubation success or failure.Endotracheal intubatio...