An assessment of the ability of impedance respirometry distinguish oesophageal from tracheal intubation

Abstract

Accidental oesophageal intubation is still an important cause of anaesthetic morbidity and mortality. This study investigated the use of impedance respirometry to determine the position of a tracheal tube. Seventy-nine patients undergoing general anaesthesia requiring tracheal intubation with muscle relaxation were recruited to the study. After pre-oxygenation, tracheal tubes were placed in both the oesophagus and trachea; a breathing system was attached to one tube chosen randomly. A blinded observer was required to correctly identify the position of the tube within six tidal ventilations. The position of every tube connected to the breathing system was correctly identified. The median time to correctly identify tracheal and oesophageal tubes was 3 and 5 s, respectively. The median number of breaths to identify tracheal and oesophageal tubes was two for both groups. Every tube position was identified within the required six breaths. Impedance respirometry is a reliable method for diagnosing tracheal tube position.