Salem M R, Wafai Y, Baraka A, Taimorrazy B, Joseph N J, Nimmagadda U
Department of Anesthesiology, Illinois Masonic Medical Center, Chicago 60657.
Anesth Analg. 1993 Dec;77(6):1227-31. doi: 10.1213/00000539-199312000-00025.
This present investigation tests the efficacy of the self-inflating bulb for detecting esophageal intubation after intentional "esophageal ventilation" to mimic gastric insufflation after bag-and-mask ventilation. In 72 anesthetized patients, the trachea and esophagus were intubated with identical tubes. The efficacy of the bulb was tested by a second anesthesiologist before and after the delivery of three breaths at a tidal volume of 300-350 mL each. The pressures generated by the bulb connected to esophageally placed tubes were measured in 10 patients. In all patients, the second anesthesiologist reported no reinflation of the bulbs when connected to esophageally placed tubes and instantaneous reinflation when connected to tracheally placed tubes, thus correctly identifying the location of each tube. The mean negative pressure generated when compressed bulbs were connected to esophageally placed tubes was 55.4 +/- 1.2 mm Hg before esophageal ventilation and 59.0 +/- 0.68 mm Hg after esophageal ventilation. We conclude that insufflation of the stomach as a result of esophageal ventilation, to the extent demonstrated in this study, does not interfere with the effectiveness of the bulb in differentiating esophageal from tracheal intubation.
本研究旨在测试自充气球囊在模拟面罩通气后胃充气的故意“食管通气”后检测食管插管的效果。在72例麻醉患者中，气管和食管插入相同的导管。由另一位麻醉医生在以每次300 - 350 mL潮气量给予三次呼吸之前和之后测试球囊的效果。在10例患者中测量连接到食管内放置导管的球囊产生的压力。在所有患者中，另一位麻醉医生报告称，当球囊连接到食管内放置的导管时不会重新充气，而连接到气管内放置的导管时会立即重新充气，从而正确识别了每根导管的位置。在食管通气前，连接到食管内放置导管的压缩球囊产生的平均负压为55.4±1.2 mmHg，食管通气后为59.0±0.68 mmHg。我们得出结论，在本研究所示的程度上，食管通气导致的胃充气并不干扰球囊区分食管插管和气管插管的有效性。
