USE OF THE SELF-INFLATING BULB FOR DETECTING ESOPHAGEAL INTUBATION AFTER ESOPHAGEAL VENTILATION

This present investigation tests the efficacy of the self-inflating bu lb for detecting esophageal intubation after intentional ''esophageal ventilation'' to mimic gastric insufflation after bag-and-mask ventila tion. In 72 anesthetized patients, the trachea and esophagus were intu bated with identical tubes. The efficacy of the bulb was tested by a s econd anesthesiologist before and after the delivery of three breaths at a tidal volume of 300-350 mL each. The pressures generated by the b ulb connected to esophageally placed tubes were measured in 10 patient s. In all patients, the second anesthesiologist reported no reinflatio n of the bulbs when connected to esophageally placed tubes and instant aneous reinflation when connected to tracheally placed tubes, thus cor rectly identifying the location of each tube. The mean negative pressu re generated when compressed bulbs were connected to esophageally plac ed tubes was 55.4 +/- 1.2 mm Hg before esophageal ventilation and 59.0 +/- 0.68 mm Hg after esophageal ventilation. We conclude that insuffl ation of the stomach as a result of esophageal ventilation, to the ext ent demonstrated in this study, does not interfere with the effectiven ess of the bulb in differentiating esophageal from tracheal intubation .