| Post-extubation stridor in intensive care unit patients. Risk factors evaluation and importance of the cuff-leak test. | |
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MedLine Citation:
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PMID: 12528025 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the incidence and identify factors associated with the occurrence of post-extubation stridor and to evaluate the performance of the cuff-leak test in detecting this complication. DESIGN: Prospective, clinical investigation. SETTING: Intensive care unit of a university hospital. PATIENTS: Hundred twelve extubations were analyzed in 112 patients during a 14-month period. INTERVENTION: A cuff-leak test before each extubation. MEASUREMENTS AND RESULTS: The incidence of stridor was 12%. When we chose the thresholds of 130 ml and 12% to quantify the cuff-leak volume, the sensitivity and the specificity of the test were, respectively, 85% and 95%. The patients who developed stridor had a cuff leak significantly lower than the others, expressed in absolute values (372+/-170 vs 59+/-92 ml, p<0.001) or in relative values (56+/-20 vs 9+/-13%, p<0.001). Stridor was associated with an elevated Simplified Acute Physiology Score (SAPS II), a medical reason for admission, a traumatic or difficult intubation, a history of self-extubation, an over-inflated balloon cuff at admission to ICU and a prolonged period of intubation. These results provide a framework with which to identify patients at risk of developing a stridor after extubation. CONCLUSION: A low cuff-leak volume (<130 ml or 12%) around the endotracheal tube prior to extubation is useful in identifying patients at risk for post-extubation stridor. |
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Authors:
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Samir Jaber; Gérald Chanques; Stefan Matecki; Michèle Ramonatxo; Christine Vergne; Bruno Souche; Pierre-François Perrigault; Jean-Jacques Eledjam |
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Publication Detail:
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Type: Journal Article Date: 2002-11-22 |
Journal Detail:
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Title: Intensive care medicine Volume: 29 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2003 Jan |
Date Detail:
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Created Date: 2003-01-15 Completed Date: 2003-06-05 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 69-74 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Intensive Care and Transplantation Unit (DAR B), Chu de Montpellier Hopital Saint Eloi, 80, avenue Augustin Fliche, 34295 Montpellier Cedex 5, France. s-jaber@chu-montpellier.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Airway Obstruction
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epidemiology,
etiology,
prevention & control* Female France / epidemiology Humans Intensive Care Units Intubation, Intratracheal / adverse effects*, instrumentation Laryngeal Edema / etiology, prevention & control Male Manometry / methods* Middle Aged Prospective Studies ROC Curve Respiratory Sounds / etiology* Risk Factors Sensitivity and Specificity Statistics, Nonparametric |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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