Abstract

STUDY OBJECTIVE:

To examine the validity of a disposable, colorimetric end-tidal CO2 detector in verifying endotracheal tube (ETT) placement in infants and children.

DESIGN:

The detector was studied prospectively in 151 intubations.

SETTING:

Operating room, ICU, and emergency department of a children's hospital.

PARTICIPANTS:

One hundred thirty-seven children undergoing endotracheal intubation for anesthesia (52), respiratory support (76), or CPR (23).

INTERVENTIONS:

After endotracheal intubation, tube position was verified, the detector was attached, and readings were obtained.

MEASUREMENTS AND RESULTS:

The detector correctly identified tube position (trachea, 124; esophagus, four) in all 120 patients who were not in cardiac arrest (P less than .01). In the cardiac arrest setting, all six esophageal intubations were correctly identified, but two of the 17 tracheal intubations were incorrectly interpreted as esophageal intubations (P less than .01).

CONCLUSION:

The detector accurately identifies ETT position in children with spontaneous circulation who weigh more than 2 kg. During CPR, a positive test correctly indicates that the ETT is in the airway, but a negative result (suggesting esophageal placement) requires an alternate means of confirming ETT position.