Chew Gordon S, Vilke Gary M, Davis Daniel P, Chan Theodore C
Department of Emergency Medicine, University of California, San Diego, Medical Center, San Diego, California 92103, USA.
J Emerg Med. 2002 Nov;23(4):337-40. doi: 10.1016/s0736-4679(02)00574-7.
We sought to determine whether gastric distention from air insufflation affects the accuracy of the Toomey syringe in detecting esophageal intubation. We conducted a randomized, single-blinded, crossover trial using human cadavers in which cuffed endotracheal (ET) tubes were placed into the esophagus and trachea. Operators used the Toomey syringe to determine the location of the ET tube before and after gastric insufflation via Ambu-bag ventilation. Greater amounts of air were aspirated (35.4 cc vs. 13.7 cc, respectively, p < 0.001) and less resistance was noted on a five-point scale (3.2 vs. 4.8, respectively, p < 0.001) from esophageally placed ET tubes after gastric insufflation. Sensitivity in detecting esophageally placed ET tubes decreased from 100% in noninsufflated cadavers to only 58% after gastric insufflation (p < 0.001). In the thawed fresh frozen cadaveric model, the Toomey syringe was unreliable in detecting an esophageal intubation after gastric distention insufflation.
我们试图确定通过空气注入造成的胃扩张是否会影响图米注射器检测食管插管的准确性。我们使用人体尸体进行了一项随机、单盲、交叉试验，在尸体中将带套囊的气管内（ET）导管分别插入食管和气管。操作人员在通过复苏球囊通气进行胃充气之前和之后，使用图米注射器来确定ET导管的位置。胃充气后，从插入食管的ET导管中抽出的空气量更多（分别为35.4毫升和13.7毫升，p<0.001），并且在五点量表上的阻力更小（分别为3.2和4.8，p<0.001）。检测插入食管的ET导管的敏感性从未充气尸体中的100%降至胃充气后的仅58%（p<0.001）。在解冻的新鲜冷冻尸体模型中，胃扩张充气后，图米注射器在检测食管插管方面不可靠。
