Tracheal airleak as a predictor of post-extubation stridor in the paediatric intensive care unit

Robert Tamburro, M. C. Bunitz

Research output: Contribution to journalArticle

Abstract

Objective: To quantify the pressure needed to generate a tracheal airleak around the endotracheal tube that might distinguish successful extubations from those with postextubation stridor. Design: Prospective, observational clinical study. Setting: The Pediatric Intensive Care Unit of a tertiary care, university hospital. Subjects: Fifty-six paediatric patients mechanically ventilated for over 24 hours without parenchymal lung disease or upper airway obstruction. Interventions: None. Measurements: Tracheal airleaks were measured prior to extubation. Main results: A tracheal airleak at 20 cm H2O of pressure identified post-extubation stridor with 100% sensitivity, 33% specificity and a positive predictive value of 18%. The absence of an airleak at 40 cm H2O identified postextubation stridor with 43% sensitivity, 80% specificity, and a positive predictive value of 23%. There was no airleak pressure that could successfully distinguish patients at risk for post-extubation stridor. Conclusions: The pressure required to generate a tracheal airleak is an unreliable predictor of post-extubation stridor in paediatric patients mechanically ventilated for over 24 hours for reasons other than parenchymal lung disease or upper airway obstruction.

Original languageEnglish (US)
Pages (from-to)52-55
Number of pages4
JournalClinical Intensive Care
Volume4
Issue number2
StatePublished - Jan 1 1993

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Pediatric Intensive Care Units
Respiratory Sounds
Pressure
Airway Obstruction
Lung Diseases
Pediatrics
Sensitivity and Specificity
Tertiary Healthcare
Observational Studies

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

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title = "Tracheal airleak as a predictor of post-extubation stridor in the paediatric intensive care unit",
abstract = "Objective: To quantify the pressure needed to generate a tracheal airleak around the endotracheal tube that might distinguish successful extubations from those with postextubation stridor. Design: Prospective, observational clinical study. Setting: The Pediatric Intensive Care Unit of a tertiary care, university hospital. Subjects: Fifty-six paediatric patients mechanically ventilated for over 24 hours without parenchymal lung disease or upper airway obstruction. Interventions: None. Measurements: Tracheal airleaks were measured prior to extubation. Main results: A tracheal airleak at 20 cm H2O of pressure identified post-extubation stridor with 100{\%} sensitivity, 33{\%} specificity and a positive predictive value of 18{\%}. The absence of an airleak at 40 cm H2O identified postextubation stridor with 43{\%} sensitivity, 80{\%} specificity, and a positive predictive value of 23{\%}. There was no airleak pressure that could successfully distinguish patients at risk for post-extubation stridor. Conclusions: The pressure required to generate a tracheal airleak is an unreliable predictor of post-extubation stridor in paediatric patients mechanically ventilated for over 24 hours for reasons other than parenchymal lung disease or upper airway obstruction.",
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Tracheal airleak as a predictor of post-extubation stridor in the paediatric intensive care unit. / Tamburro, Robert; Bunitz, M. C.

In: Clinical Intensive Care, Vol. 4, No. 2, 01.01.1993, p. 52-55.

Research output: Contribution to journalArticle

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AU - Tamburro, Robert

AU - Bunitz, M. C.

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N2 - Objective: To quantify the pressure needed to generate a tracheal airleak around the endotracheal tube that might distinguish successful extubations from those with postextubation stridor. Design: Prospective, observational clinical study. Setting: The Pediatric Intensive Care Unit of a tertiary care, university hospital. Subjects: Fifty-six paediatric patients mechanically ventilated for over 24 hours without parenchymal lung disease or upper airway obstruction. Interventions: None. Measurements: Tracheal airleaks were measured prior to extubation. Main results: A tracheal airleak at 20 cm H2O of pressure identified post-extubation stridor with 100% sensitivity, 33% specificity and a positive predictive value of 18%. The absence of an airleak at 40 cm H2O identified postextubation stridor with 43% sensitivity, 80% specificity, and a positive predictive value of 23%. There was no airleak pressure that could successfully distinguish patients at risk for post-extubation stridor. Conclusions: The pressure required to generate a tracheal airleak is an unreliable predictor of post-extubation stridor in paediatric patients mechanically ventilated for over 24 hours for reasons other than parenchymal lung disease or upper airway obstruction.

AB - Objective: To quantify the pressure needed to generate a tracheal airleak around the endotracheal tube that might distinguish successful extubations from those with postextubation stridor. Design: Prospective, observational clinical study. Setting: The Pediatric Intensive Care Unit of a tertiary care, university hospital. Subjects: Fifty-six paediatric patients mechanically ventilated for over 24 hours without parenchymal lung disease or upper airway obstruction. Interventions: None. Measurements: Tracheal airleaks were measured prior to extubation. Main results: A tracheal airleak at 20 cm H2O of pressure identified post-extubation stridor with 100% sensitivity, 33% specificity and a positive predictive value of 18%. The absence of an airleak at 40 cm H2O identified postextubation stridor with 43% sensitivity, 80% specificity, and a positive predictive value of 23%. There was no airleak pressure that could successfully distinguish patients at risk for post-extubation stridor. Conclusions: The pressure required to generate a tracheal airleak is an unreliable predictor of post-extubation stridor in paediatric patients mechanically ventilated for over 24 hours for reasons other than parenchymal lung disease or upper airway obstruction.

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