Kadry Tahir, Harvey Martyn, Wallace Muir, Imrie Justin
Department of Emergency Medicine, Waikato Hospital, Hamilton, New Zealand.
Emerg Med Australas. 2007 Jun;19(3):203-6. doi: 10.1111/j.1742-6723.2007.00926.x.
Intubating catheters (e.g. gum-elastic bougie) are an invaluable adjunct in the management of a difficult airway. Traditional tactile 'click' (from tracheal rings) and 'hold up' (from carina or bronchus) techniques for confirming tracheal placement are, however, fallible, and definitive placement can only be confirmed following passage of the endotracheal tube. Ensuing delays might contribute to the development of arterial hypoxaemia. Our aim was to determine whether an aspirating oesophageal detector device might be useful for confirming placement of the Frova intubating catheter (a hollow-bore intubating catheter).
Eighteen adult patients (American Society of Anaesthiology category 1-2) undergoing elective surgery had the Frova intubating catheter alternately placed in the trachea, or oesophagus, following induction of anaesthesia. Catheter position was assessed using an aspirating oesophageal detector device prior to tracheal intubation.
The oesophageal detector device correctly predicted tracheal (n = 18) and oesophageal (n = 18) placement in all patients. All procedures were completed in less than 15 s.
In the operating theatre setting the aspirating oesophageal detector device reliably predicts tracheal and oesophageal placement of the Frova intubating catheter.
插管导管(如弹性胶棒)在困难气道处理中是非常重要的辅助工具。然而,传统通过触觉感受气管环产生的“咔哒”声以及隆突或支气管产生的“阻挡感”来确认气管插管位置的方法存在误差,只有在气管内导管插入后才能确定最终位置。由此产生的延迟可能会导致动脉血氧不足。我们的目的是确定一种可抽吸的食管探测装置是否有助于确认弗罗瓦插管导管(一种中空孔道的插管导管)的位置。
18例接受择期手术的成年患者(美国麻醉医师协会分级1 - 2级)在麻醉诱导后,将弗罗瓦插管导管交替置于气管或食管内。在气管插管前,使用可抽吸的食管探测装置评估导管位置。
食管探测装置在所有患者中均正确预测了气管(n = 18)和食管(n = 18)的位置。所有操作均在15秒内完成。
在手术室环境中,可抽吸的食管探测装置能够可靠地预测弗罗瓦插管导管在气管和食管的位置。