ASSESSMENT OF THE PROPER DEPTH OF ENDOTRACHEAL-TUBE PLACEMENT WITH THE TRACHLIGHT

Study objective: To test the hypothesis that the correct depth of the endotracheal tube can be confirmed by transillumination method using t he Trachlight(TM) device, which is a newly introduced lighted stylet f or guided, blind tracheal intubation. Design: Prospective, nonrandomiz ed pilot-trial. Setting: University-affiliated hospital. Patients: 72 intubated and mechanically ventilated critically ill adult patients. I nterventions: Patients were briefly disconnected from the respirator T he centimeter marks of the Trachlight(TM) catheter were brought into l ine with those of the endotracheal tube, resulting in congruence of th e bulb of the Trachlight(TM) and the tube tip. Measurements and Main R esults: To measure the distance from the tip of the tube to that of th e sternal notch, the Trachlight(TM) wand was retracted without moving the endotracheal tube until the bright light appeared in the sternal n otch. A chest radiography was taken to measure the distance between th e carina and the tip of the tube. The Trachlight(TM) showed a distance of 4.0 +/- 1.3 cm from the tip of the tube to the sternal notch. Ches t radiography revealed a distance of 3.3 +/- 1.6 cm between the carina and the tip of the tube, so that the calculated distance between ster nal notch and carina was 7.3 +/- 1.5 cm. Conclusion: To achieve proper depth of the endotracheal tube, it is recommended that the tip of the endotracheal tube be placed 3 cm beyond the sternal notch. The Trachl ight(TM) provides a simple and easy technique to achieve this goal. (C ) 1998 by Elsevier Science Inc.