We hypothesized that the accuracy of the modified cuff leak test in predicting re-intubation in tracheal intubated patients is better than that of the conventional balloon leak test, thereby further reducing the re-intubation rate.

The cuff leak test is an effective method for predicting the occurrence of upper airway obstruction in patients with endotracheal intubation after extubation, with high specificity and moderate sensitivity. However, there is still no clear and unified cuff leak test operation specification. A cohort study has proposed a modified method. When the patient is placed in a semi-recumbent position of 60 degrees and the ventilator is set to a low-flow square wave, it is more predictive than conventional methods. We hypothesized that the accuracy of the modified cuff leak test in predicting re-intubation in tracheal intubated patients is better than that of the conventional balloon leak test, thereby further reducing the re-intubation rate.

Inclusion Criteria:

• Age ≥ 18 years old
• Oral endotracheal intubation and mechanical ventilation > 36 hours
• Fulfilled the weaning criteria

Exclusion Criteria:

• The patient has a chest drainage tube and there is persistent air leak
• Abnormalities of the larynx: such as tumors or vocal cord paralysis
• The patient cannot maintain the semi-recumbent position
• Unconventional weaning, such as awake ECMO, etc
• Participated in the study during the hospitalization
• Patients or their relatives refused written informed consent