The cuff leak test in critically ill patients: An international survey of intensivists
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- Kimberley Lewis
- Division of Critical Care Department of Medicine McMaster University Hamilton Canada
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- Yousef Almubarak
- College of Medicine Department of Internal Medicine and Critical Care Imam Abdulrahman Ben Faisal University Al Khobar Kingdom of Saudi Arabia
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- Morten Hylander Møller
- Department of Intensive Care Medicine Copenhagen University Hospital Rigshspitalet Denmark
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- Roman Jaeschke
- Division of Critical Care Department of Medicine McMaster University Hamilton Canada
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- Dan Perri
- Division of Critical Care Department of Medicine McMaster University Hamilton Canada
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- Ying Zhang
- Center for Evidence‐Based Chinese Medicine Beijing University of Chinese Medicine Beijing China
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- Bin Du
- Medical ICU Peking Union Medical College Hospital Beijing China
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- Osamu Nishida
- Department of Anesthesiology and Critical Care Medicine Fujita Health University School of Medicine Aichi Japan
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- George Ntoumenopoulos
- Physiotherapy Department St Vincent's Hospital Sydney Australia
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- Manoj Saxena
- The George Institute for Global Health University of New South Wales Sydney Australia
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- Jonathon Truwit
- Department of Pulmonary and Critical Care Medicine Froedtert and Medical College of Wisconsin Milwaukee WI USA
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- Paul J. Young
- Intensive Care Unit, Wellington Hospital Capital and Coast District Health Board Wellington New Zealand
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- Fayez Alshamsi
- Department of Internal Medicine College of Medicine and Health Sciences United Arab Emirates University Alain United Arab Emirates
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- Yaseen M. Arabi
- College of Medicine Intensive Care Department King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center Ministry of National Guard Health Affairs Riyadh Saudi Arabia
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- Bram Rochwerg
- Division of Critical Care Department of Medicine McMaster University Hamilton Canada
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- Tim Karachi
- Division of Critical Care Department of Medicine McMaster University Hamilton Canada
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- Wojciech Szczeklik
- Center for Intensive Care and Perioperative Medicine Jagiellonian University Medical College Krakow Poland
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- Muhammed Alshahrani
- College of Medicine Department of Emergency and Critical Care Imam Abdulrahman Ben Faisal University Al Khobar Kingdom of Saudi Arabia
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- Flavia R Machado
- Anesthesiology, Pain, and Intensive Care Department Universidade Federal de São Paulo São Paulo Brazil
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- Djillali Annane
- Department of Intensive Care Medicine University of Versailles SQY University Paris Saclay Raymond Poincare Hospital (AP‐HP) Garches France
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- Massimo Antonelli
- Istituto di Anestesia e Risnimazione Fondazione Policlinico Universitario A. Gemelli IRCCS‐ Università Cattolica del Sacro Cuore Rome Italy
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- Timothy D. Girard
- Clinical Research, Investigation, and Systems Modeling of Acute illness (CRISMA) Center in the Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh PA USA
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- Deborah Cook
- Division of Critical Care Department of Medicine McMaster University Hamilton Canada
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- Bandar Baw
- Clinical Pharmacology and Toxicology McMaster University Hamilton Canada
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- Rahul Nanchal
- Division of Pulmonary and Critical Care Medicine Medical College of Wisconsin Milwaukee WI USA
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- Thomas Piraino
- Division of Critical Care St. Michael's Hospital Toronto Canada
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- Gordon Guyatt
- Division of Critical Care Department of Medicine McMaster University Hamilton Canada
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- Waleed Alhazzani
- Division of Critical Care Department of Medicine McMaster University Hamilton Canada
説明
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>The cuff leak test (CLT) is used to assess laryngeal edema prior to extubation. There is limited evidence for its diagnostic accuracy and conflicting guidelines surrounding its use in critically ill patients who do not have risk factors for laryngeal edema. The primary study aim was to describe intensivists' beliefs, attitudes, and practice regarding the use of the CLT.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A 13‐item survey was developed, pilot‐tested, and subjected to clinical sensibility testing. The survey was distributed electronically through MetaClinician®. Descriptive statistics and multivariable regression analysis were performed to examine associations between participant demographics and survey responses.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>1184 practicing intensivists from 17 countries in North and South America, Europe, Oceania, and Asia participated. The majority (59%) of respondents reported rarely or never perform the CLT prior to extubating patients not at high risk of laryngeal edema, which correlated with 54% of respondents reporting they believed a failed CLT did not predict reintubation. Intensivists from the Middle East were 2.4 times more likely to request a CLT compared to those from North America. Intensivists with base training in medicine or emergency medicine were more likely to request a CLT prior to extubation compared to those with base training in anesthesiology.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Use of the CLT prior to extubating patients not at high risk of laryngeal edema in the intensive care unit is highly variable. Practice appears to be influenced by country of practice and base specialty training.</jats:p></jats:sec>
収録刊行物
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- Acta Anaesthesiologica Scandinavica
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Acta Anaesthesiologica Scandinavica 65 (8), 1087-1094, 2021-06-16
Wiley
