Complications of Endotracheal Intubation

Adriani, John; Naraghi, Mohsen; Ward, M. E.

doi:10.1097/00007611-198806000-00014

Cited by 14 publications

(8 citation statements)

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“…Unrecognized esophageal intubation is a relatively infrequent but potentially devastating complication of emergency airway management (1,2). Although many strategies for endotracheal (ET) tube confirmation have been proposed, none has emerged as ideal in all situations (3).…”

Section: Introductionmentioning

confidence: 99%

The Sensitivity and Specificity of Transcricothyroid Ultrasonography to Confirm Endotracheal Tube Placement in a Cadaver Model

Davis

Schmitt

et al. 2007

The Journal of Emergency Medicine

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Section: Introductionmentioning

confidence: 99%

The Sensitivity and Specificity of Transcricothyroid Ultrasonography to Confirm Endotracheal Tube Placement in a Cadaver Model

Davis

Schmitt

et al. 2007

The Journal of Emergency Medicine

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“…16 The carina is found approximately at the level of the second rib. 13 The average distance from the vocal cords to the carina is 12.7 cm, with a standard deviation of 1.6 cm. 3 This estimate, however, is extremely variable and is affected by age, race, and gender, among other factors.…”

Section: Discussionmentioning

confidence: 99%

“…4 Many authors have shown that effective lung auscultation is highly skill dependent and can be misleading nearly two thirds of the time. 2,12,13 The use of endotracheal tubes with a Murphy eye can result in bilateral breath sounds in 48% of patients who have an esophageal intubation and in 60% of patients who have a main-stem intubation. 6,14,15 The trachea, in most adult patients, is between 10 and 15 cm long, beginning at the cricoid cartilage and ending at the carina.…”

Section: Discussionmentioning

confidence: 99%

Inadvertent Endobronchial Intubation in a Patient With a Short Neck Length

Cornelius

Sakai

2015

Anesthesia Progress

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Inadvertent placement of the endotracheal tube into the right bronchus during intubation for general anesthesia is a fairly common occurrence. Many precautions should be taken by the anesthesia provider in order to minimize the incidence of endobronchial intubation, including bilateral auscultation of the lungs, use of the 21/23 rule, and palpation of the inflated endotracheal cuff at the sternal notch. These provisions, however, are not foolproof; anesthesia providers should realize that endobronchial intubation may occur from time to time because of variations in patient anatomy, changes in patient positioning, and cephalad pressures exerted during surgery. A 58-year-old man with chronic obstructive pulmonary disease received general endotracheal anesthesia for a laparoscopic cholecystectomy. His height was 165 cm (5 ft, 5 in) and the endotracheal tube was secured at his incisors at 21 cm after placement with a rigid laryngoscope. Bilateral breath sounds were confirmed with auscultation, although they were distant because of his chronic obstructive pulmonary disease. After radiographic examination in the postanesthesia care unit, a right main-stem intubation was revealed to have taken place, resulting in complete atelectasis of the left lung. After repositioning of the endotracheal tube, radiography confirmed that the patient had an anatomically short tracheal length.

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“…[3] Unrecognized intubation of the esophagus is relatively infrequent, but is followed by morbidity and mortality. [456]…”

Section: Introductionmentioning

confidence: 99%

Secondary confirmation of endotracheal tube position by diaphragm motion in right subcostal ultrasound view

Hosseini

Talebian

Ghafari

et al. 2013

Int J Crit Illn Inj Sci

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Aims:To assess the sensitivity and specificity of right subcostal ultrasound view to confirm correct endotracheal tube intubation (ETT).Materials and Methods:In this prospective study, apneic or paralyzed patients who had an indication of intubation were selected. Intubation and ventilation with bag were performed by the skilled third-year emergency medicine residents. The residents, following a brief training course of ultrasonography, interpreted the diaphragm motion, and identified either esophageal or tracheal intubation. The confirmation of ETT placement was done by the sonographer. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for tracheal versus esophageal intubation.Results:A total of 57 patients aged 59 ± 5 who underwent ETT insertion were studied. Thirty-four of them were male (60%). Ultrasound correctly identified 11 out of 12 esophageal intubations for a sensitivity of 92% (95% CI = 62-100), but misidentified one esophageal intubation as tracheal. Sonographers correctly identified 43 out of 45 (96%) tracheal intubations for a specificity of 96% (95% CI = 85-99), but misdiagnosed two tracheal intubations as esophageal.Conclusions:This study suggests that diaphragm motion in right subcostal ultrasound view is an effective adjunct to diagnose ETT place in patients undergoing intubation in emergency department.

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Complications of Endotracheal Intubation

Cited by 14 publications

References 0 publications

The Sensitivity and Specificity of Transcricothyroid Ultrasonography to Confirm Endotracheal Tube Placement in a Cadaver Model

The Sensitivity and Specificity of Transcricothyroid Ultrasonography to Confirm Endotracheal Tube Placement in a Cadaver Model

Inadvertent Endobronchial Intubation in a Patient With a Short Neck Length

Secondary confirmation of endotracheal tube position by diaphragm motion in right subcostal ultrasound view

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