Frova intubating catheter position can be determined with aspirating oesophageal detection device

Abstract

Intubating catheters (e.g. gum-elastic bougie) are an invaluable adjunct in the management of a difficult airway. Traditional tactile 'click' (from tracheal rings) and 'hold up' (from carina or bronchus) techniques for confirming tracheal placement are, however, fallible, and definitive placement can only be confirmed following passage of the endotracheal tube. Ensuing delays might contribute to the development of arterial hypoxaemia. Our aim was to determine whether an aspirating oesophageal detector device might be useful for confirming placement of the Frova intubating catheter (a hollow-bore intubating catheter). Eighteen adult patients (American Society of Anaesthiology category 1-2) undergoing elective surgery had the Frova intubating catheter alternately placed in the trachea, or oesophagus, following induction of anaesthesia. Catheter position was assessed using an aspirating oesophageal detector device prior to tracheal intubation. The oesophageal detector device correctly predicted tracheal (n = 18) and oesophageal (n = 18) placement in all patients. All procedures were completed in less than 15 s. In the operating theatre setting the aspirating oesophageal detector device reliably predicts tracheal and oesophageal placement of the Frova intubating catheter.