Direct laryngoscopy to predict extubation success following a failed cuff leak test in intensive care patients

•Performing direct laryngoscopy in the Intensive Care Unit for patients who failed an endotracheal cuff leak test may allow some of these patients to be extubated immediately and successfully.•This extubation process may mitigate many hours of unnecessary invasive ventilation.•Direct laryngoscopy in ICU patients who fail an endotracheal cuff leak test may allow immediate and successful extubation.•Current guideline recommendations for corticosteroid administration in patients who fail a cuff leak test may be inordinate.