- 期刊
Detection of Airway CO2 Partial Pressure to Avoid Esophageal Intubation
偵測氣道內二氧化碳分壓以避免氣管插管誤入食道
摘要
進行氣管插管時，檢查插管位置以避免誤入食道極為重要，因為對病危的病人，此種情況常造成嚴重的併發症。本研究分析50例在小兒加護病房中作緊急氣管插管時所測得的二氧化碳分壓，以評估二氧化碳分析儀對於早期偵測食道插管和調整氣管插管適當位置的效用。結果顯示如下，一、在成功的氣管插管中，吐氣二氧化碳分壓介於10到80毫米汞柱之間，並有典型的呼吸波形。二、當氣管插管誤入食道時，吐氣二氧化碳分壓小於5毫米汞柱且無明顯呼吸波形。三、單肺插管或氣管插管外拔至聲門以上時，吐氣二氧化碳分壓會降低，待調整至適當位置時則上升。所以能夠連續偵側吐氣二氧化碳分壓的分析儀(capnography)可說是一種可靠，簡單，快速的工具，可立即偵測氣管插管誤入食道的情況，並能評估插管在氣管中的深淺位置是否適當。
關鍵字
文摘並列摘要
During endotracheal intubation, checking the position of endotracheal tube is important in order to avoid accidental esophageal intubation. Exhaled CO2 pressures of 50 emergent intubation attempts were recorded in our pediatric intensive unit to evaluate the efficacy of capnography in the early detection of esophageal intubation. Adjustment of the tube position was performed when indicated. In successful endotracheal intubation, the end-tidal CO2 pressures (PetCO2) ranged from 10 mmHg to 80 mmHg with typical respiratory phasic waveforms. In cases of inadvertent esophageal intubation, the PetCO2 values were less than S mmHg and revealed no typical respiratory pattern. It was also observed that PetCO2 decreased during one lung intubation or when the tip of endotracheal tube was pulled above the glottis. Capnographic monitoring end-tidal CO2 pressure continuously may be a reliable, time-saving tool for the detection of inadvertent esophageal intubation and the evaluation of proper positioning of the endotracheal tube.