Longitud de inserción del tubo orotraqueal. Comparación de la predicción del clínico con las medidas broncoscópicas. Pseudónimo: Tráquea

Longitud de inserción del tubo orotraqueal. Comparación de la predicción del clínico con las medidas broncoscópicas. Pseudónimo: Tráquea

Background: lnappropiate position of endotra-cheal tube are very common. First step in the intubation process, blind decission about lenght of insertion, never has been subject of investigation.

Objective: To compare clinical prediction of the lenght of insertion with objective measures taken during fiberoptic bronchoscopy.

Design: Cross-sectional study.

Setting: Bronchoscopy unit al Hospital Santa Clara, Santafé de Bogotá.

Patients and Methods: Adult patients requiring nonurgent bronchoscopy. Befare the endoscopic procedure experienced e/inician were asked about estimated height and weight of the patient and about appopiate /enght of insertion of endotracheal tube in the case of emergency intubation. At the endoscopy comisure to carina distance was registered and the appropiate length range for the position of the tube was calculated. Main com-parison was trecuence of agreement between clínica/ prediction and the calculated range based in endoscopic measures.

Results: In 39 out of 65 patients included length of insertion predicted by the e/inician was in the range based in endoscopic measures. Predicted length was considered lower than expected in 4 and excesive in 22. However, median difference in the two nonappropiateposition groups was only 1 cm.

Conclusions: lnitial length of insertion of endotracheal tubes selected by the e/inician is appropiate in more than 60% of the cases and the remaining errors are mínima/, probably with no clínica/ implication. First step in the intubation process appears as ve¡y precisse.