Cuff-leak test combined with interventional bronchoscopy benefits early extubation for patients who received tarp surgery
This study explored the performance characteristics of a cuff-leak test (CLT) combined with interventional fiberoptic bronchoscopy (FBS) for evaluating whether early nasoendotracheal extubation was possible for patients who had received transoral atlantoaxial reduction plate (TARP) internal fixation surgery.
318 patients who underwent surgery were retrospectively analyzed (between January 2006 and December 2012). Extubation was performed by conventional approach (CA group, until December 2008) and improved approach (IA group, from January 2009) including CLT and an interventional FBS procedure. The extubation success within 1–3 days after surgery, incidence of postextubation stridor and tracheal reintubation were examined.
More IA-treated patients experienced extubation during the first 2 days than those CA-treated, median extubation time was 3 (2, 3) days in the CA group and 2 (1, 2) days in the IA group (all P < 0.01). The incidence of stridor and reintubation was 5.69 and 0.57 % in IA and 11.98 and 4.93 % in CA, respectively (both P < 0.05). For the CLT-positive patients in the IA group that remained intubated until day 3–4, interventional FBS was applied for safe extubation and achieved 100 % success.
Early extubation through IA is safe and interventional FBS assists successful extubation for CLT-positive patients who underwent TARP surgery.
KeywordsTARP Cuff-leak test Fiberoptic bronchoscopy Nasoendotracheal extubation Stridor and tracheal reintubation
Transoral atlantoaxial reduction plate
Oxygen saturation measured by pulse oximetry
- M ± SD
Mean ± standard deviation
Statistical package for the social science
Chi square test
The second cervical vertebral body
This work was supported in part by grant BSW11C065 from key subjects of military medical scientific research fund of China.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interests.
- 12.Benjamin B, Holinger LD (2008) Laryngeal complications of endotracheal intubation. Ann Otol Rhinol Laryngol 117(Suppl 200):1–20Google Scholar