Nicoll S J, King C J
Department of Anaesthesia, Guy's Hospital, London, UK.
Anaesthesia. 1998 Jan;53(1):41-5. doi: 10.1111/j.1365-2044.1998.00273.x.
Unrecognised accidental oesophageal intubation remains an important cause of morbidity and mortality in anaesthetic practice. We have evaluated a new method of distinguishing tracheal from oesophageal intubation using a simple adaptation of an ordinary stethoscope which is inserted into the patient end of the breathing system. We call this technique 'airway auscultation'. Characteristic sounds are heard with the stethoscope during inflation and deflation which allow the observer to diagnose the position of the tube. When the tube is in the trachea loud breath sounds are heard. In contrast, when the tube is in the oesophagus either squeaks or a flatus-like noise is heard or else there is no sound. In 100 healthy adults two observers rapidly identified 99 intubations correctly in a randomised single-blind trial. We recommend further widespread evaluation of this device as it appears to be an effective, simple and rapid method of detecting oesophageal intubation and confirming tracheal intubation which may be of particular use in situations where capnography is not available.
未被识别的意外食管插管仍然是麻醉实践中发病和死亡的重要原因。我们评估了一种新方法，通过对插入呼吸系统患者端的普通听诊器进行简单改装，来区分气管插管和食管插管。我们将这种技术称为“气道听诊”。在充气和放气过程中，用听诊器可以听到特征性声音，使观察者能够诊断导管的位置。当导管在气管内时，可以听到响亮的呼吸音。相比之下，当导管在食管内时，会听到吱吱声或类似肠胃气胀的声音，或者根本没有声音。在一项随机单盲试验中，两名观察者在100名健康成年人中迅速正确识别出99次插管情况。我们建议对该设备进行进一步广泛评估，因为它似乎是一种检测食管插管和确认气管插管的有效、简单且快速的方法，在无法进行二氧化碳描记法的情况下可能特别有用。
