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SHR Neuro Cancer Cardio Lipid Metab Microb
Schmölzer, GM; Poulton, DA; Dawson, JA; Kamlin, CO; Morley, CJ; Davis, PG.
Assessment of flow waves and colorimetric CO(2) detector for endotracheal tube placement during neonatal resuscitation.
Resuscitation. 2011; 82(3): 307-312.
Doi: 10.1016/j.resuscitation.2010.11.008
Web of Science
PubMed
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- Schmölzer Georg
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- Aim: Clinical assessment and end-tidal CO2 (ETCO2) detectors are routinely used to verify endotracheal tube (ETT) placement. However. ETCO2 detectors may mislead clinicians by failing to identify correct placement under a variety of conditions. A flow sensor measures gas flow in and out of an ETT. We reviewed video recordings of neonatal resuscitations to compare a colorimetric CO2 detector (Pedi-Cap (R)) with flow sensor recordings for assessing ETT placement. Methods: We reviewed recordings of infants <32 w(e)eks gestation born between February 2007 and January 2010. Airway pressures and gas flow were recorded with a respiratory function monitor. Video recording were used (i) to identify infants who were intubated in the delivery room and (ii) to observe colour change of the ETCO2 detector. Flow sensor recordings were used to confirm whether the tube was in the trachea or not. Results: Of the 210 infants recorded, 44 infants were intubated in the delivery room. Data from 77 intubation attempts were analysed. In 35 intubations of 20 infants both a PediCap (R) and flow sensor were available for analysis. In 21(60%) intubations, both methods correctly identified successful ETT placement and in 3 (9%) both indicated the FIT was not in the trachea. In the remaining 11(31%) intubations the PediCap (R) failed to change colour despite the flow wave indicating correct ETT placement. Conclusion: Colorimetric CO2 detectors may mislead clinicians intubating very preterm infants in the delivery room. They may fail to change colour in spite of correct tube placement in up to one third of the cases. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Carbon Dioxide - analysis
- Cardiopulmonary Resuscitation - methods
- Colorimetry -
- Delivery Rooms -
- Humans -
- Infant, Newborn -
- Intubation, Intratracheal - methods
- Monitoring, Physiologic - methods
- Resuscitation - methods
- Rheology -
- Video Recording -
- Find related publications in this database (Keywords)
- Infants
- Delivery room
- Intubation
- Respiratory function monitor
- Neonatal resuscitation
- Calorimetric carbon dioxide detector