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Case report
False-positive Cuff Leak Test Due to Glossoptosis: A Case Report
Jun-ya Ishikawa
Tokyo Women's Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1425-8876
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The cuff leak test (CLT) can sometimes be falsely positive. We report a case with a visually confirmed false-positive cuff leak test caused by upper airway obstruction due to glossoptosis.
Case presentation
A 62-year-old woman was diagnosed with subarachnoid hemorrhage due to a ruptured aneurysm and underwent high-flow bypass and trapping. Postoperatively, she was admitted to our intensive care unit under mechanical ventilation. On postoperative days 11 and 13, she had positive CLTs under sedation. We observed only mild to moderate edema around the vocal cords and tracheal tube cuff using a bronchoscope and muscle relaxant. Bronchoscopy showed glossoptosis; hence, a jaw-lift maneuver was performed and the CLT turned negative. The false-positive CLT was thought to be due to glossoptosis. She was extubated on postoperative day 15 without post-extubation stridor. She was discharged on postoperative day 41.
Conclusions
Upper airway obstruction due to glossoptosis can cause false positive CLT. We should consider a jaw-thrust maneuver to avoid a false positive when performing CLT on a sedated patient.
Keywords
Cuff leak test, false-positive, post-extubation stridor, laryngeal edema, tracheal intubation, glossoptosis, jaw-thrust maneuver
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This is a preprint. It has not completed peer review.
Case report
False-positive Cuff Leak Test Due to Glossoptosis: A Case Report
Jun-ya Ishikawa
Tokyo Women's Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1425-8876
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 16 Dec, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The cuff leak test (CLT) can sometimes be falsely positive. We report a case with a visually confirmed false-positive cuff leak test caused by upper airway obstruction due to glossoptosis.
Case presentation
A 62-year-old woman was diagnosed with subarachnoid hemorrhage due to a ruptured aneurysm and underwent high-flow bypass and trapping. Postoperatively, she was admitted to our intensive care unit under mechanical ventilation. On postoperative days 11 and 13, she had positive CLTs under sedation. We observed only mild to moderate edema around the vocal cords and tracheal tube cuff using a bronchoscope and muscle relaxant. Bronchoscopy showed glossoptosis; hence, a jaw-lift maneuver was performed and the CLT turned negative. The false-positive CLT was thought to be due to glossoptosis. She was extubated on postoperative day 15 without post-extubation stridor. She was discharged on postoperative day 41.
Conclusions
Upper airway obstruction due to glossoptosis can cause false positive CLT. We should consider a jaw-thrust maneuver to avoid a false positive when performing CLT on a sedated patient.
Figure 1
Figure 1
Figure 2
Figure 2