Evaluation of a flexible fiberoptic catheter in confirming endotracheal tube placement in the intensive care unit.

UNLABELLED

We evaluated the use of an inexpensive 2.2-mm fiberoptic catheter (FOC) to assess endotracheal tube (ETT) placement in 22 critically ill adult patients.

METHOD

The distance between the carina and the distal tip of the ETT was measured under direct visualization with the FOC and compared to the corresponding measurement obtained from concomitant chest radiographs.

RESULTS

There was a significant linear correlation between measurements made by the two methods (r = 0.97, P less than 0.0001), and all FOC measurements were within 1 cm of the corresponding radiograph measurements. No complications or significant changes occurred in peak airway pressure, tidal volume, respiratory rate, or heart rate. The procedure usually was performed in less than 1 minute. Cost analysis revealed the possibility of major savings when the FOC is used instead of portable chest radiography.

CONCLUSIONS

We conclude that documentation of endotracheal tube placement by means of a fiberoptic catheter is rapid, accurate, safe, and cost-effective.