Bronchial electrocardiography to determine left or right main bronchial placement of an endotracheal suction catheter tip.
OBJECTIVE
To assess the utility of a blue lined angle tipped and electrode tipped catheter, to guide left and right main bronchus cannulation.


METHODS
A prospective study.


METHODS
An 11-bed general intensive care unit in a 900-bed teaching hospital.


METHODS
50 intubated intensive care patients, in sinus rhythm with normal P and QRS mean frontal axis, who required endobronchial suctioning for routine respiratory management.


METHODS
Endobronchial electrocardiography was used to position a blue lined angle tipped and electrode tipped suction catheter into the right and left main bronchi.


RESULTS
Selective cannulation of the left main bronchi was determined by observing a biphasic or inverted P wave in 42 patients, or biphasic or inverted QRS complex in 31 patients. In 8 patients in whom no changes in the ECG were found, bronchoscopic placement of an ECG electrode into the left main bronchus demonstrated a biphasic or inverted P wave in 8 patients and a biphasic QRS complex in 3 patients, confirming the failure to cannulate the left main bronchus in these 8 patients.


CONCLUSIONS
Using a blue lined, angle tipped and electrode tipped catheter for endotracheal suctioning, endobronchial electrocardiography may be a simple method to signal left or right main bronchus cannulation.
Worthley
L I
LI
Intensive Care Unit, Flinders Medical Centre, Bedford Park, Australia.
D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000209:etiology; D001980:Bronchi; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D004566:Electrodes / Q000592:standards*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000592:standards*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity