기관내삽관후 흉부 X-선 촬영을 통한 기관내관의 이상위치 빈도와 이에 영향을 주는 요인

• Published in: Korean journal of anesthesiology Vol. 33; no. 1; pp. 98 - 103
• Main Authors: 윤경섭, Kyoung Seop Yoon, 이경민, Kyung Min Lee, 임현교, Hyun Kyo Lim, 엄대자, Dae Ja Um
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회(구 대한마취과학회) 30-07-1997
• Subjects: Intubation; malposition. Equipment; tracheal; tubes
• ISSN: 2005-6419; 2005-7563

Background : Malpositioning of the endotracheal tube within airway after intubation may results in serious complications, such as accidental extubation and inadvertent endobronchial intubation. Therefore, early detection of malposioning of the endotracheal tube is very impotant for deciding patient's prognosis. Methods : We assessed the distance from the tip of the endotracheal tube to the carina according to the patient's age, sex, and the time, the location, and the route of intubation. The chest x-ray was taken for 333 patients(men, 226: women, 107) who were admitted to the intensive care unit of Wonju Christian Hospital from march 1, 1995 to February 28, 1996. Chest x-ray was obtained after intubation to verify endotracheal tube position. Appropriate endotracheal tube position on chest x-ray was defined as between 2 and 6 cm above the carina. Results : Of the 333 intubations, 106(31.8%) endotracheal tubes were inappropriately placed according to the chest x-ray. The percentage of malpositioned endotracheal tubes(<2 cm) was higher in women than in men(11.2% vs. 5.3%, p<0.05), with higher in night(7 PM to 7 AM) than in day(7 AM to 7 PM)(42% vs. 24%, p<0.05). Distance from the carina to the tip of endotracheal tube is 4.34±1.77cm in women and 5.23±1.64cm in men. Thus, position of the endotracheal tube in women is deeper than men(P<0.001). Conclusions : We conclude that the chest x-ray for confirmation of endotracheal tube position after endotracheal intubation may remain the standard of practice. And endotracheal tube position should be carefully assessed immediately after tracheal intubation, particularly in women and at night. (Korean J Anesthesiol 1997; 33: 98∼103)