A patient in the ICU who has successfully completed a 120-minute SBT requires extubation. Which of the following tests or values would indicate the potential for airway edema after extu-bation?

a. PImax
b. VC
c. Cuff leak test
d. Oxygen saturation measured by pulse ox-imeter (SpO2)

ANS: C
The cuff leak test is a means of testing for post-extubation airway patency. Note that to qualify for this test, the patient must no longer need ventilatory support. To perform this test, the patient is disconnected from the ventilator, the cuff is deflated, and the ET or tracheostomy tube is ob-structed. A leak around the cuff (peritubular leak) during spontaneous breathing suggests that the airway caliber is adequate and successful extubation is likely. A leak of less than 110 mL (aver-age of three values on six consecutive breaths) indicates a high risk of post-extubation stridor. Treatment with steroids or racemic epinephrine (or both) before extubation may be indicated.