title: Application of the self-inflating bulb to a hollow intubating introducer.
abstract: BACKGROUND
  The aspiration test, performed by a self-inflating bulb (SIB), is a simple and reliable method to detect an accidental esophageal intubation. The aim of the study, in case of employment of a hollow intubating introducer (HII), was to verify the possibility to directly perform the test with the introducer and its efficacy in allowing the detection of its position.
  
  
  METHODS
  
  
  
  METHODS
  prospective, randomized study.
  
  
  METHODS
  operating theater in a university hospital.
  
  
  METHODS
  adult patients, without evidence of gastro-esophageal or tracheobronchial pathologies, scheduled for elective surgery.
  
  
  METHODS
  patients were randomized in two groups T (HII was placed in trachea) and E (HII was positioned in the esophagus). Under general anesthesia, a HII was placed in either the trachea or the esophagus. A blinded anesthesiologist connected the SIB to the HII and performed the test twice.
  
  
  METHODS
  the anesthesiologist inferred the position of the device, based on the re-inflation observed.
  
  
  RESULTS
  One hundred subjects were studied. In group E patients, a prompt and complete re-inflation of the bulb was never observed and the anesthesiologist correctly inferred the position of the HII. Occasionally (3.5% of cases), in group T patients, a prevented or incomplete re-inflation of the bulb occurred, leading to an incorrect judgment of the HII position.
  
  
  CONCLUSIONS
  The aspiration test with the SIB allows the proper detection of the introducer in esophagus. When used in combination with a HII, both time and local trauma associated with an erroneous, introducer-guided esophageal intubation in case of difficult laryngoscopy may be reduced.
authors.affiliation: I Servizio di Anestesia e Rianimazione, Spedali Civili, Brescia, Italy. danieletuzzo@hotmail.com
authors.forename: D M
authors.initials: DM
authors.lastname: Tuzzo
authors.forename: G
authors.initials: G
authors.lastname: Frova
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017558:Elective Surgical Procedures; D004867:Equipment Design; D004868:Equipment Failure; D004947:Esophagus; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013396:Suction; D014132:Trachea