Document Detail

Comparison of three oxygen monitors in detecting endobronchial intubation.
MedLine Citation:
PMID:  3193146     Owner:  NLM     Status:  MEDLINE    
Rapid and reliable detection of inadvertent endobronchial intubation is an essential function of oxygen monitoring. We have studied the detection of this event by using three oxygen monitoring techniques: pulse oximetry, transcutaneous measurement of oxygen tension, and intraarterial fiberoptic measurement of oxygen tension. Four dogs were anesthetized, intubated, and monitored with these three techniques and with arterial and central venous cannulas. Endotracheal tubes were moved from the trachea into the right mainstem bronchi at several inspired oxygen fraction (FIO2) values for each dog, and the responses of the oxygen monitors were recorded for 20 minutes thereafter. The pulse oximeter showed little change in oxygen saturation (SpO2) during endobronchial intubation at FIO2 values above 0.3. SpO2 decreased by an average of 1.3 +/- 2.1% at an FIO2 of 1.0 and by 4.0 +/- 4.1% at an FIO2 of 0.5. Simultaneously measured transcutaneous oxygen tensions decreased by 42 to 64% and the optode reading decreased by 64 to 79%. At lower FIO2 values, the changes in SpO2 were more significant: a decrease of 6.0 +/- 6.3% at an FIO2 of 0.3 and of 9.8 +/- 6.1% at an FIO2 of 0.2. The transcutaneous oxygen and optode readings decreased by 31 to 45% under these conditions. Endobronchial intubations at FIO2 values greater than 0.3 may not yield immediate decreases in arterial saturation and hence may go undetected by pulse oximetry. Transcutaneous oxygen tension decreases significantly with endobronchial intubation at any FIO2. The experimental, intraarterial optode consistently yielded the greatest changes with the fastest time response.
S J Barker; K K Tremper; J Hyatt; H Heitzmann
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of clinical monitoring     Volume:  4     ISSN:  0748-1977     ISO Abbreviation:  J Clin Monit     Publication Date:  1988 Oct 
Date Detail:
Created Date:  1988-12-28     Completed Date:  1988-12-28     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8506707     Medline TA:  J Clin Monit     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  240-3     Citation Subset:  IM    
Department of Anesthesiology, University of California, Irvine Medical Center, Orange 92668.
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MeSH Terms
Anesthesia, Inhalation / adverse effects
Anoxia / diagnosis*,  etiology
Blood Gas Monitoring, Transcutaneous
Fiber Optic Technology
Monitoring, Physiologic / methods*
Oxygen / blood
Reg. No./Substance:

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