Use of an optical fiber scope to confirm endotracheal tube placement in pediatric patients

Objective: To determine the efficacy of a portable optical fiber scope to c onfirm endotracheal tube (ETT) placement. Design: A prospective, nonrandomized, blinded study. Setting: Pediatric intensive care unit in a children's hospital. Patients: Thirty mechanically ventilated patients with an ETT in place. Interventions: Patients entered into the study underwent ETT placement dete rmination by chest roentgenogram (CXR) and by the optical fiber scope. Measurements and Main Results: Thirty patients were entered into the study, for a total of 46 measurements (n = 46), ETT size ranged from 3.0 to 6.0 m m internal diameter. Distance from the ETT and the carina was determined by the scope and compared with the distance measured on the CXR. No statistic al difference was found between the two methods. None of the patients exper ienced clinically significant side effects from the procedure. On three occ asions, the presence of secretions in the ETT did not allow for the visuali zation of the carina by the scope. Conclusion: The use of a flexible optical fiber scope is an accurate, fast, and practical method to determine ETT placement in pediatric patients on m echanical ventilation.