OBJECTIVE: To evaluate whether a simple aspiration test can be used to accurately confirm the correct placement of fine-bore feeding tubes in the oesophagus and prevent their inadvertent placement in the bronchial tree. DESIGN: We conducted an ethically approved, randomised, blinded trial to assess the accuracy of a simple aspiration test to differentiate between oesophageal and tracheal placement. SETTING: A tertiary referral cardiothoracic surgical unit. PATIENTS AND PARTICIPANTS: Twenty patients under-going elective cardiac surgery. INTERVENTION: Once anesthetised, a fine-bore feeding tube was inserted into the oesophagus or trachea and a researcher, blinded to the position, then performed the test. This involved attempted aspiration of > or =10 ml of air before and after insufflation of 10 ml of air and comparison with capnography, a test that has been shown to be highly sensitive and specific. MEASUREMENTS AND RESULTS: With this small number of patients, the test accurately differentiated between ten oesophageal and ten tracheal placements. CONCLUSIONS: A simple aspiration test could be a useful adjunct to prevent inadvertent bronchial placement of fine-bore feeding tubes. Careful attention must be paid to the technique to ensure that no false positives occur.
RCT Entities:
OBJECTIVE: To evaluate whether a simple aspiration test can be used to accurately confirm the correct placement of fine-bore feeding tubes in the oesophagus and prevent their inadvertent placement in the bronchial tree. DESIGN: We conducted an ethically approved, randomised, blinded trial to assess the accuracy of a simple aspiration test to differentiate between oesophageal and tracheal placement. SETTING: A tertiary referral cardiothoracic surgical unit. PATIENTS AND PARTICIPANTS: Twenty patients under-going elective cardiac surgery. INTERVENTION: Once anesthetised, a fine-bore feeding tube was inserted into the oesophagus or trachea and a researcher, blinded to the position, then performed the test. This involved attempted aspiration of > or =10 ml of air before and after insufflation of 10 ml of air and comparison with capnography, a test that has been shown to be highly sensitive and specific. MEASUREMENTS AND RESULTS: With this small number of patients, the test accurately differentiated between ten oesophageal and ten tracheal placements. CONCLUSIONS: A simple aspiration test could be a useful adjunct to prevent inadvertent bronchial placement of fine-bore feeding tubes. Careful attention must be paid to the technique to ensure that no false positives occur.
Authors: A M Harrison; B Clay; M J Grant; S V Sanders; H F Webster; J C Reading; J M Dean; M K Witte Journal: Crit Care Med Date: 1997-12 Impact factor: 7.598
Authors: Carlos E Araujo-Preza; Mauricio E Melhado; Francisco J Gutierrez; Theodore Maniatis; Michael A Castellano Journal: Crit Care Med Date: 2002-10 Impact factor: 7.598
Authors: Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; François Lemaire; Herwig Gerlach; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Jean-Charles Preiser; Jerôme Pugin; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2010-01-08 Impact factor: 17.440