Comparison between traditional measures and airway column in postextubation stridor

Background While the majority of stridor cases do not necessitate medical treatment, there are instances where it may result in reintubation due to upper airway obstruction. Aim This study aimed to evaluate the effectiveness of traditional assessment methods versus airway column width measurements in predicting postextubation stridor among patients in an emergency ICU who are on mechanical ventilation. Patients and methods This study was designed as a prospective randomized comparative investigation involving 90 patients, aged 18–60 years, representing both sexes, who had undergone intubation and mechanical ventilation for a duration exceeding 24 h. The participants were randomly divided into two equal cohorts: group A underwent a cuff leak test to assess air leaks, using appropriately sized cuffed endotracheal tubes, while group B had their air column width evaluated via ultrasound to measure edema. Results Cuff leak volume and percentage can significantly predict patients developed postextubation stridor ( P <0.001 and area under the curve=0.784) at a cut-off less than or equal to 129 ml for the volume and less than or equal to 13% for the percentage with 83.33% sensitivity, 76.92% specificity, 35.7% positive predictive value, and 96.8% negative predictive value. Air column width difference can significantly predict patients developed postextubation stridor ( P <0.001 and area under the curve=0.872) at cut-off less than 0.9 with 75% sensitivity, 87.8% specificity, 37.5% positive predictive value, and 97.3% negative predictive value. Conclusions Laryngeal ultrasonography is a reliable, noninvasive alternative for assessing vocal cord functionality, laryngeal anatomy, and airflow dynamics in intubated patients compared to the cuff leak test.