Abstract
Abstract In 49 adult anaesthetised patients an endotracheal tube was advanced into the right main bronchus and then withdrawn until breath-sounds were heard on the left side of the chest. Thereafter the effect on the position of the tube of the Trendelenburg tilt and of other manœuvres which may raise the diaphragm were studied. In 20 of the 49 patients there was radiological evidence of upward displacement of the carina. In 10 of these the carina was displaced upwards more than the endotracheal tube, which had been firmly anchored at the patient's mouth. As a result, the tube either seemed to be lower in the airways than in the control X-ray, or the trachea was curved at the tip of the tube. In most of these 10 patients there was auscultatory evidence of impaired ventilation of the left lung. But auscultation did not always produce unequivocal evidence of bronchial intubation.
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