Holland R, Webb R K, Runciman W B
Department of Anaesthesia and Intensive Care, University of Newcastle, N.S.W.
Anaesth Intensive Care. 1993 Oct;21(5):608-10. doi: 10.1177/0310057X9302100519.
There were 35 oesophageal intubations in the first 2000 incidents reported to the Australian Incident Monitoring Study (AIMS). These reports confirm existing impressions that misplacement of the endotracheal tube can occur in trained as well as untrained hands, and that auscultation is an unreliable test. On the other hand, the value of capnography is emphasised, with no false positives in the 16 cases in which the instrument was used. There was one false negative. Over the 4 years of the AIMS study, reports have declined in frequency. It is possible that the early detection of oesophageal intubation by capnography has altered its status to the extent that anaesthetists no longer regard it as a "critical" incident. It is highly recommended that the presence of the expected concentration of carbon dioxide in expired air be confirmed by capnography immediately after any endotracheal intubation.
在向澳大利亚事件监测研究（AIMS）报告的最初2000起事件中，有35例发生了食管插管。这些报告证实了现有的观点，即气管插管误入食管在训练有素和未经训练的人员操作中均可能发生，并且听诊是一项不可靠的检查。另一方面，强调了二氧化碳监测的价值，在使用该仪器的16例病例中没有假阳性结果。有1例假阴性。在AIMS研究的4年中，报告的频率有所下降。通过二氧化碳监测早期发现食管插管可能已经在很大程度上改变了其状况，以至于麻醉医生不再将其视为“危急”事件。强烈建议在任何气管插管后立即通过二氧化碳监测确认呼出气体中是否存在预期浓度的二氧化碳。
