Chest radiography after endotracheal tube placement: is it necessary or not?

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Abstract

Purpose

The aim of this study was to evaluate the necessity of chest x-ray (CXR) in detecting the endotracheal tube (ETT) misplacement after the intubation.

Basic procedures

In this cross-sectional study, we took a CXR after confirming the ETT placement by physical examination. The distance between the tip of the ETT and carina was then evaluated and graded as satisfactory if it was more than 2 cm.

Main findings

During the study period, 381 patients were intubated in the emergency department (ED). According to the CXR findings, the distance between the ETT and carina was more than 2 cm in 336 patients (88.2%), whereas it was less than 2 cm in 45 patients (11.8%). Fourteen ETTs (3.6%) were judged to be too low with 6 (1.5%) of these being right bronchus intubations. One patient had a CXR confirming left bronchial intubation.

Principal conclusions

Although ED intubations have high success rate, the complications of inappropriate intubations are highly remarkable that postintubation CXR remains a necessary step to minimize the misplacement of the tube.

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