PT  - JOURNAL ARTICLE
AU  - Sukhen Samanta
AU  - Afzal Azim
AU  - Arvind Baronia
AU  - Banani Poddar
AU  - Mohan Gurjar
AU  - Ratender Singh
TI  - Late Breaking Abstract - Clinical risk, cuff leak test and laryngeal ultrasound based scoring system to predict post-extubation stridor in intensive care unit patients
AID  - 10.1183/13993003.congress-2019.PA2293
DP  - 2019 Sep 28
TA  - European Respiratory Journal
PG  - PA2293
VI  - 54
IP  - suppl 63
4099  - http://erj.ersjournals.com/content/54/suppl_63/PA2293.short
4100  - http://erj.ersjournals.com/content/54/suppl_63/PA2293.full
SO  - Eur Respir J2019 Sep 28; 54
AB  - Background: Laryngeal oedema often presents as post-extubation stridor (PES). There are not enough evidences in the literature for the most appropriate method to predict PES.Objectives: We conducted this study to determine the diagnostic accuracy of a score derived from clinical risk factors, portable laryngeal ultrasound and cuff leak test for prediction of PES.Methods: In this pilot study, patients who were admitted in the intensive care unit and intubated for >24 hours were included. Laryngeal ultrasound measured air column width (ACW), air column width differences (ACWD = air column post deflation – air column pre deflation ) and air column width ratio (ACWR=air column width before extubation/ after intubation). Cuff leak test was performed before extubation. All clinical risk factors were noted. Based on clinical risk factors, cuff leak volume and laryngeal sonography parameters a scoring system (RCS) was derived. The patients were compared between two groups; PES group and no PES group.Results: The incidence of post extubation stridor was 21% (11/52). Overall performance of RCS score for diagnosis of PES is good with a sensitivity, specificity of 82%, 93% respectively. Individual parameter like risk factor>2, cuff leak <110 millilitres, ACWD and ACWR to predict PES had sensitivity and specificity of 45%,95%;18%,97%;91%,68%;55%,92% respectively. The area under curve for RCS score was 0.873 whereas risk factor>2, cuff leak <110 millilitres, ACWD and ACWR were 0.703,0.597,0,796,0.736 respectively.Conclusions: Risk, cuff leak and sonography based RCS score of ≥3 can better predict post extubation stridor than individual parameter.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2293.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).