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首页> 外文期刊>Prehospital emergency care >Evaluation of an electronic esophageal detector device in patients with morbid obesity and pulmonary failure.
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Evaluation of an electronic esophageal detector device in patients with morbid obesity and pulmonary failure.

机译：病态肥胖和肺功能衰竭患者的电子食管检测器设备评估。

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OBJECTIVE: Undetected esophageal intubation can result in permanent injury or death. Clinical confirmation of tube location may be misleading. Adjunctive methods should be used to supplement clinical judgment. Unfortunately, end-tidal carbon dioxide may misidentify properly placed tracheal tubes in low perfusion situations, while esophageal detector devices (EDDs) may misidentify properly placed tracheal tubes in situations where little airway dead space exists (morbid obesity, pulmonary failure). This study evaluated a modified EDD (the electronic esophageal detector device, or EEDD) designed to eliminate the problem of misidentified tracheal intubations. METHODS: Intubated morbidly obese or pulmonary failure patients were eligible for study entry. All endotracheal tubes (ETTs) were confirmed to be tracheal by waveform capnography and clinical judgment prior to study entry. Following consent, all patients were attached to the EEDD and a "measurement" was made to determine the location intubation in these high-risk populations was calculated using a log-normal distribution method. RESULTS: Twenty-seven morbidly obese patients and 37 pulmonary failure patients were entered. The EEDD correctly identified all tracheal intubations in these patients, giving a false-negative rate of zero. The probability of misidentifying a tracheal intubation in the combined group was 0.06%. CONCLUSION: This study demonstrates that the EEDD reliably identifies tracheal intubations in situations where standard EDDs may fail. However, future studies must determine the reliability of this device for identification of esophageal intubations and the reliability of this device in the less controlled emergency department and prehospital settings.
机译：目的：未发现食管插管可导致永久性伤害或死亡。管位置的临床确认可能会产生误导。应使用辅助方法来补充临床判断。不幸的是，在低灌注情况下，潮气末二氧化碳可能会误判正确放置的气管导管，而在气道死角很少的情况下（病态肥胖，肺衰竭），食道检测器设备（EDD）可能会误判正确放置的气管导管。这项研究评估了一种改良的EDD（电子食管探测器设备或EEDD），旨在消除误认气管插管的问题。方法：经插管的病态肥胖或肺衰竭患者有资格参加研究。在进入研究之前，通过波形二氧化碳图和临床判断确认所有气管插管（ETTs）均处于气管状态。同意后，所有患者均接受EEDD治疗，并通过对数正态分布方法计算“测量值”，以确定这些高危人群中的位置插管。结果：27例病态肥胖患者和37例肺衰竭患者进入。 EEDD正确识别了这些患者的所有气管插管，假阴性率为零。合并组中误认气管插管的可能性为0.06％。结论：本研究表明，在标准EDD可能失败的情况下，EEDD能够可靠地识别气管插管。但是，未来的研究必须确定该设备用于识别食管插管的可靠性，以及在控制较少的急诊室和院前环境中该设备的可靠性。

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