tailieunhanh - Báo cáo y học: "The cuff-leak test: what are we measuring"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: The cuff-leak test: what are we measuring? | Available online http content 9 1 31 Commentary The cuff-leak test what are we measuring Daniel De Backer Assistant Professor Department of Intensive Care Erasme University Hospital Free University of Brussels Belgium Corresponding author Daniel De Backer ddebacke@ Published online 17 December 2004 This article is online at http content 9 1 31 2004 BioMed Central Ltd See Research by Prinianakis et al. page 119 Critical Care 2005 9 31-33 DOI cc3031 Abstract Stridor is one of the most frequent causes of early extubation failure. The cuff-leak test may help to identify patients at risk to develop post-extubation laryngeal edema. However the discrimination power of the cuff-leak test is highly variable and can be use at best to detect patients at risk to develop edema but should not be used to postpone extubation as tracheal extubation can still be successful in many patients with a positive test. In this editorial the author discuss the factors influencing the leak and hence its predictive value. Keywords extubation failure laryngeal edema stridor Tracheal extubation of patients is still a major challenge with the possibility of post-extubation stridor and then re-intubation if the patient is unable to sustain the increase in respiratory work. Stridor is responsible for 15-38 of extubation failures 1-3 and for close to 38 of early extubation failures 3 . Recognition of stridor is important because these patients can benefit from close monitoring and from specific therapies including non-invasive respiratory assistance aerosolized adrenaline epinephrine and steroids even though the efficacy of steroids remains under debate . Ideally patients at risk of developing laryngeal edema should be identified as early as possible and the cuff-leak test has been proposed for this purpose. The principle of this test is quite simple and is based on the fact that the air leak around a tracheal tube with a cuff deflated will be inversely .