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The esophageal detector device. Does it work?
L Zaleski1, D Abello, M I Gold
1Department of Anesthesiology, University of Miami School of Medicine, Florida.
Anesthesiology
|August 1, 1993
Summary
The esophageal detector device (EDD) accurately confirms tracheal intubation, matching capnography results in all cases. While generally reliable, the EDD showed slow bulb reinflation in 6% of tracheal intubations.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Emergency Medicine
Background:
- The esophageal detector device (EDD) is a tool for confirming tracheal intubation.
- Capnography is the current gold standard for confirming correct endotracheal tube placement.
- Investigating the agreement between EDD and capnography is crucial for patient safety.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the esophageal detector device (EDD).
- To compare the performance of the EDD against capnography in confirming tracheal intubation.
- To determine the reliability of the EDD in various intubation scenarios.
Main Methods:
- Three studies involving 500 patients were conducted to assess EDD performance.
- Tracheal and esophageal intubations were simulated and tested using both EDD and capnography.
- A double-blind, randomized design was employed in one study to minimize bias.
Main Results:
- The EDD demonstrated 100% agreement with capnography in confirming tracheal intubation across all studies.
- In 6% of tracheal intubations, the EDD bulb exhibited delayed reinflation (5-30 seconds).
- The EDD showed 100% sensitivity, specificity, and predictive value for correct intubation.
Conclusions:
- The esophageal detector device (EDD) is a reliable tool for confirming tracheal intubation.
- EDD results consistently align with capnography, offering a valuable alternative or adjunct.
- The EDD is particularly useful in settings lacking capnography, such as hospital wards.