{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T17:06:12Z","timestamp":1767891972758,"version":"3.49.0"},"reference-count":9,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T00:00:00Z","timestamp":1570492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the accuracy of the minimum leak test as a surrogate for target endotracheal cuff pressure of 20\u201330 cm H<jats:sub>2<\/jats:sub>O in intubated patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cuff pressures were measured at the University of Miami Hospital using the minimum leak test on every intubated patient once per shift, then cuff pressure was reevaluated using handheld numerical manometers and recorded pressures above or below the target range, readjusting the pressure as needed. This assessment was repeated throughout each patient's intubation for up to 6\u2009days. The readjustment rate of the test and the probability of a patient needing at least one adjustment were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred twenty\u2010two patients were evaluated. Median age was 67\u2009years (range 29\u201395), 52% were male, 48% were female. Patients were followed for an average of 4.7\u2009days. Seven hundred twenty\u2010two minimum leak tests were performed. Of these, 170 required readjustment into the target range (24% readjustment rate). Of the tests outside target range, 66% of cuffs were overinflated and 34% were underinflated. Fifty\u2010five percent of patients required at least one adjustment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite ubiquitous use of the minimum leak test for endotracheal cuff pressure adjustment, the test has an unacceptably high error rate resulting in cuff pressures above or below the target range. Most patients will require at least one adjustment throughout an intubation, putting them at risk for tracheal injury, stenosis, or leak and aspiration. The minimum leak test is not sufficiently accurate for endotracheal cuff pressure monitoring. Formal manometry is superior and should be used to optimize patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 130:1646\u20131650, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28328","type":"journal-article","created":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T15:31:06Z","timestamp":1570548666000},"page":"1646-1650","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Accuracy of the minimal leak test for endotracheal cuff pressure monitoring"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-4594","authenticated-orcid":false,"given":"Yamil","family":"Selman","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Miami  Miami Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Arciniegas","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, the Department of Medicine University of Miami  Miami Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M.","family":"Sabra","sequence":"additional","affiliation":[{"name":"Miller School of Medicine University of Miami  Miami Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanira D.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, the Department of Medicine University of Miami  Miami Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Miami  Miami Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2011661"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2011.09.001"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-197904000-00018"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.87.6.720"},{"key":"e_1_2_6_6_1","first-page":"252","article-title":"Tracheal stenosis and cuff pressure: comparison of minimal occlusive volume and palpation techniques","volume":"14","author":"Totonchi Z","year":"2015","journal-title":"Tanaffos"},{"key":"e_1_2_6_7_1","first-page":"15","article-title":"Continuous monitoring of endotracheal tube cuff pressure: best practice in intensive care unit","volume":"34","author":"Danielis M","year":"2015","journal-title":"Assist Inferm Ric"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2009441"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.01812"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2016.09.002"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.28328","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28328","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.28328","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28328","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T10:08:56Z","timestamp":1693994936000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.28328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,8]]},"references-count":9,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1002\/lary.28328"],"URL":"https:\/\/doi.org\/10.1002\/lary.28328","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,8]]},"assertion":[{"value":"2019-03-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}