What does a cuff leak around the endotracheal tube indicate?

• A. A leak around the deflated cuff indicates lower airway edema and reduced risk of post-extubation stridor.
• B. A leak indicates severe edema.
• C. No leak means the airway is always ready.
• D. A leak confirms tube placement.

Answer: (A)

A cuff leak around the endotracheal tube after deflating the cuff reflects that air can pass around the tube, meaning there isn’t significant edema in the upper airway (laryngeal area). This patency around the tube is what lowers the risk of post-extubation stridor, because with less swelling there’s less tendency for the airway to narrow once the tube is removed. Conversely, little or no leak suggests substantial laryngeal edema and a higher risk of extubation failure or stridor, prompting caution or delay and possibly treatments to reduce edema.

So a leak around the cuff indicates a lower likelihood of problematic upper airway edema and a reduced risk of post-extubation stridor. It does not assess tube placement, and absence of a leak does not mean the airway is never ready for extubation.