A novel method to position an endotracheal tube at the correct depth using an infrared sensor stylet
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REPORTS OF ORIGINAL INVESTIGATIONS
A novel method to position an endotracheal tube at the correct depth using an infrared sensor stylet Une me´thode innovante pour positionner une sonde endotrache´ale a` la bonne profondeur avec un mandrin muni d’un capteur infrarouge Yeongtak Song, Msc • Jaehoon Oh, MD • Youngjoon Chee, PhD • Taeho Lim, MD, PhD • Hyunggoo Kang, MD • Youngsuk Cho, MD Received: 27 August 2012 / Accepted: 25 January 2013 / Published online: 1 February 2013 Ó Canadian Anesthesiologists’ Society 2013
Abstract Purpose This study is a feasibility assessment to determine the ability of novice users to utilize an infrared (IR) sensor stylet as a guide to position the tip of the endotracheal tube (ETT) 40 mm proximal to the carina in the swine trachea. Methods We developed a stylet system using an IR sensor attached to the tip of a stylet to facilitate measuring the distance of the ETT from the carina. The indicator lamp of the IR sensor system turns on through calibration when the ETT tip arrives at a point 20 mm proximal to the carina. In order to place the ETT tip 40 mm (middle of 20-60 mm) from the carina after the indicator lamp turns on, the operator uses the ETT marker to withdraw the ETT 20 mm. For this study, five fresh swine airways were used in random order after drawing lots, and ten novices were
Author contributions Jaehoon Oh and Youngjoon Chee helped with study conception and design and obtained research funding. Youngjoon Chee, Hyunggoo Kang, and Yeongtak Song developed the sensor and recording system. Taeho Lim and Youngsuk Cho supervised the conduct of the trial and data collection. Jaehoon Oh, Youngjoon Chee, and Youngsuk Cho recruited the participants and managed the data, including quality control. Yeongtak Song drafted the manuscript. All authors read and contributed to the manuscript and approved the revisions. Jaehoon Oh assumes responsibility for the paper as a whole. Y. Song, Msc Y. Chee, PhD School of Electrical Engineering, University of Ulsan, Ulsan, South Korea J. Oh, MD (&) T. Lim, MD, PhD H. Kang, MD Y. Cho, MD Department of Emergency Medicine, College of Medicine, Hanyang University, Wangsimni 222, Seongdong-Gu, Seoul, South Korea e-mail: [email protected]
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recruited to attempt the procedure ten times on each swine’s airway. Results Five hundred endotracheal intubations were performed. For the target distance of 40 mm from the ETT tip to the carina, the mean (standard deviation) of the total data set was 37.9 (3.5) mm; all data were within a 20-60 mm range (500/500), and 98.2% (491/500) of the attempts fell within the 30-50 mm range. Conclusions The IR sensor stylet system can facilitate correct positioning of the ETT tip at an appropriate depth above the carina in the swine trachea. Evaluation of the IR sensor stylet methodology in human subjects is warranted. Re´sume´ Objectif Cette e´tude est une e´valuation de faisabilite´ pour de´terminer la capacite´ de novices de se servir d’un mandrin muni d’un capteur infrarouge (IR) comme guide pour placer l’extre´mit
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