Journal of Cardiothoracic and Vascular Anesthesia
Volume 21, Issue 2 , Pages 197-202 , April 2007

The Air-Leak Test Is Not a Good Predictor of Postextubation Adverse Events in Children Undergoing Cardiac Surgery

  • Pertti K. Suominen, MD, PhD

      Affiliations

    • Department of Anesthesia and Intensive Care, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
    • Corresponding Author InformationAddress reprint requests to Pertti Suominen, MD, PhD, Penn State Milton S. Hershey Medical Center, Department of Anesthesiology, 500 University Drive, POB 850, Hershey, PA 17033-0850.
    • ,
  • Netta A. Tuominen, MD

      Affiliations

    • Department of Anesthesia and Intensive Care, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
    • ,
  • Jukka T. Salminen, MD, PhD

      Affiliations

    • Department of Paediatric Surgery, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland.
    • ,
  • Reijo E. Korpela, MD

      Affiliations

    • Department of Anesthesia and Intensive Care, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
    • ,
  • Jaakko G.M. Klockars, MD

      Affiliations

    • Department of Anesthesia and Intensive Care, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
    • ,
  • Tomi R. Taivainen, MD, PhD

      Affiliations

    • Department of Anesthesia and Intensive Care, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
    • ,
  • Olli A. Meretoja, MD, PhD

      Affiliations

    • Department of Anesthesia and Intensive Care, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland

References 

  1. Newth CJL, Hammer J. Pulmonary issues. In:  Chang AC,  Hanley FL,  Wernowsky G, et al. editor. Pediatric Cardiac Intensive Careed 1. Baltimore, MD: Williams & Wilkins; 1998;p. 351–367
  2. Harrison MA, Cox AC, Davis S, et al. Failed extubation after cardiac surgery in young children: Prevalence, pathogenesis, and risk factors. Pediatr Crit Care Med. 2002;2:148–152
  3. Karsli CH, Isaac LA, Roy WL. Induction of anesthesia. In:  Bissonnette B,  Dalens BJ editor. Pediatric Anesthesia Principles and Practice. ed 1. New York, NY: McGraw-Hill; 2002;p. 483–527
  4. Koka BV, Jeon IS, Andre JM, et al. Postintubation croup in children. Anesth Analg. 1977;56:501–505
  5. Finholt DA, Henry DB, Raphaely RC. Factors affecting leak around tracheal tubes in children. Can Anaesth Soc J. 1985;32:326–329
  6. Schwartz RE, Stayer SA, Pasquariello CA. Tracheal tube leak test—Is there inter-observer agreement?. Can J Anaesth. 1993;40:1049–1052
  7. Adderley RJ, Mullins GC. When to extubate the croup patient: The “leak” test. Can J Anesth. 1987;34:304–306
  8. Seid AB, Godin MS, Pransky SM, et al. The prognostic value of endotracheal tube—air leak following tracheal surgery in children. Arch Otolaryngol Head Neck Surg. 1991;117:880–882
  9. Kemper KJ, Benson MS, Bishop MJ. Predictors of postextubation stridor in pediatric trauma patients. Crit Care Med. 1991;19:352–355
  10. Walker I, Lockie J. Basic techniques for anaesthesia. In:  Sumner E,  Hatch DJ editor. Paediatric Anaesthesia. ed 2. London: Arnold; 1999;p. 165–207
  11. Slutsky AS. Mechanical ventilation (American College of Chest Physicians’ Consensus Conference). Chest. 1993;104:1833–1859
  12. Marraro GA. Innovative practices of ventilatory support with pediatric patients. Pediatr Crit Care Med. 2003;4:8–20
  13. McElhinney DB, Petrossian E, Reddy VM, et al. Extracardiac conduit Fontan procedure without cardiopulmonary bypass. Ann Thorac Surg. 1998;66:1826–1828
  14. Suominen P, Taivainen T, Tuominen N, et al. Optimally fitted tracheal tubes decrease the probability of postextubation adverse events in children undergoing general anaesthesia. Paediatr Anaesth. 2006;16:641–647
  15. Seegobin RD, van Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow: Endoscopic study of effects of four large volume cuffs. BMJ. 1984;288:965–968
  16. Dullenkopf A, Gerber AC, Weiss M. Fit and seal characteristics of a new paediatric tracheal tube with high-volume low-pressure polyurethane cuff. Acta Anaesthesiol Scand. 2005;49:232–237
  17. Kurachek SC, Newth CJ, Quasney MW, et al. Extubation failure in pediatric intensive care: A multiple-center study of risk factors and outcomes. Crit Care Med. 2003;31:2657–2664
  18. Smith JH, O’Kelly SW. Brain swelling after coronary artery surgery. Lancet. 1993;342:370–1371(letter)
  19. Khine HH, Corddry DH, Kettrick RG, et al. Comparison of cuffed and uncuffed endotracheal tubes in young children during general anesthesia. Anesthesiology. 1997;86:627–631
  20. Mhanna MJ, Zamel YB, Tichy CM, et al. The “air-leak test” around the endotracheal tube, as a predictor of postextubation stridor, is age dependent in children. Crit Care Med. 2002;30:2639–2643

 Supported by the Foundation of Päivi and Sakari Sohlberg.

PII: S1053-0770(06)00044-9

doi: 10.1053/j.jvca.2006.01.007

Journal of Cardiothoracic and Vascular Anesthesia
Volume 21, Issue 2 , Pages 197-202 , April 2007

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