Heller R M, Cotton R B
Pediatrics. 1985 Apr;75(4):664-6.
A major problem in the care of premature and other newborn infants is obtaining and maintaining correct position of an endotracheal tube. Improper placement of the distal tip of the endotracheal tube above the larynx or below the carina is a life-threatening hazard that not only impairs ventilation, but also may result in serious pulmonary complications such as lobar atelectasis and air leak. This problem was addressed by testing the hypothesis that a light source at the end of the endotracheal tube could be seen on the neck and chest and that, therefore, the endotracheal tube could be positioned and repositioned without radiologic guidance. The validity of this concept was confirmed in animals using a rigid bronchoscope light source and conventional endotracheal tubes. Then an endotracheal tube in which a fiberoptic strand was incorporated in the wall and which terminated near the tip of the tube was used. The illuminated endotracheal tube was used 33 times in 25 infants. This technique has been shown to provide a safe method (not requiring ionizing radiation) for positioning of the endotracheal tube by virtue of external visualization of a circle of light on the surface of the baby. This system will not permit differentiation of tracheal from esophageal intubation.
在早产儿及其他新生儿护理中，一个主要问题是如何获取并维持气管内导管的正确位置。气管内导管远端置于喉上方或隆突下方均会带来危及生命的风险，不仅会影响通气，还可能导致严重的肺部并发症，如肺叶不张和气漏。为解决这一问题，我们对以下假设进行了验证：气管内导管末端的光源在颈部和胸部可见，因此无需放射学引导即可对气管内导管进行定位和重新定位。在动物实验中，使用硬支气管镜光源和传统气管内导管证实了这一概念的有效性。随后使用了一种在管壁中嵌入光纤束且在导管末端附近终止的气管内导管。这种带照明的气管内导管在25例婴儿中使用了33次。该技术已被证明是一种安全的方法（无需电离辐射），可通过观察婴儿体表的光环来定位气管内导管。但该系统无法区分气管插管和食管插管。
