Prompt correction of endotracheal tube positioning after intubation prevents further inappropriate positions
| Autor: | Mona Boaz, Shmuel Evron, Simon Jackobashvilli, Dimitry Trigub, Nugzar Rigini, Tiberiu Ezri, Alexander Izakson |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Insufflation
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Auscultation Thyromental distance Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Bronchoscopy Anesthesia mental disorders Medicine Intubation Abdomen business Laparoscopy psychological phenomena and processes Endotracheal tube |
| Zdroj: | Journal of Clinical Anesthesia. 23:367-371 |
| ISSN: | 0952-8180 |
| DOI: | 10.1016/j.jclinane.2010.11.002 |
| Popis: | Study Objective To determine whether the timely correction of endotracheal tube (ETT) positioning prevents further inappropriate positions. Design Prospective crossover study. Setting University-affiliated hospital. Patients 44 adult, ASA physical status 1, 2, and 3 patients undergoing open or laparoscopic abdominal procedures. Interventions ETT positioning was verified by both auscultation and fiberoptic bronchoscopy (FOB), after intubation, and before extubation. In laparoscopic procedures, two additional measurements were performed: after maximal abdominal gas insufflation and with head-down position. An ETT in the bronchus or at the carina was considered an inappropriate placement. An ETT ≤ one cm from the carina was considered a critical placement. Measurements The frequency of inappropriate and critical ETT positioning with both auscultation and FOB and the number of ETTs that remained in an incorrect position despite repositioning. Main Results FOB detected 5 inappropriately positioned ETTs, 4 of which were also detected by chest auscultation ( P = 0.99). Critical positioning was detected by FOB in 6 patients, three of which were also detected by auscultation ( P = 0.24). There were 15 other "out-of-desired range" positions (out of the 3-5 cm range) – one placed too high and 14 placed too low, while 18 were placed within the range of positions. All patients with inappropriate ETT positioning were women ( P = 0.005). Age, body mass index, Mallampati grade > 3, thyromental distance Conclusions Early detection and prompt correction of inappropriate ETT positioning after intubation prevented further ETT migration into undesired positions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect