Objective: The purpose of this study is to determine
the accuracy of the cuff-leak test in a cardiovascular ICU.
Methods: Five hundred twenty-four patients were tested
immediately before being extubated 531 times. The cuff-leak test was
performed with the ventilator set in assist-control mode at a tidal
volume (Vt) of 10 to 12 mL/kg. The leak was taken to be the
difference between the preset inspiratory Vt and the
average of the three lowest of the subsequent six expiratory
Vts. A leak ≤ 110 mL was considered to be a positive leak
Results: None of the 20 patients with a positive
leak test developed problems. Three patients had postextubation
stridor. Their leaks were 433, 312, and 350 mL.
Conclusion: The cuff-leak test is inaccurate and cannot be
recommended for routine use in this population.