2012 Fiscal Year Final Research Report
Reliability of Chest Auscultation in Determining Proper Position of Tracheal Tubes
| Project/Area Number |
22592262
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Surgical dentistry
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| Research Institution | Kagoshima University |
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Principal Investigator |
SUGIYAMA Kazuna 鹿児島大学, 大学院・医歯学総合研究科, 教授 (50124772)
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| Co-Investigator(Kenkyū-buntansha) |
MANABE Yozo 鹿児島大学, 医学部・歯学部附属病院, 講師 (90248550)
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| Project Period (FY) |
2010 – 2012
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| Keywords | 気管チューブ / 呼吸音 / 片肺挿管 / マーフィーアイ、カフ / 低酸素血症 |
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| Research Abstract |
Unreliability of breath sounds auscultation after intubation is reportedly mainly related to the presence of the Murphy eye. This study was performed to ascertain whether cuffed and uncuffed tracheal tubes with the Murphy eyes increases the risk of unrecognized bronchial intubation, compared to tubes without eyes. The present study demonstrates that a stethoscope can recognize the change in breath sounds only when gas flow to the left lung remarkably decreases, indicating that a stethoscope is unable to detect the slight decrease in gas flow resulting from advancement of the tube tip beyond the carina. With use of a cuffed tube, the inflated cuff can seal the space between the tube and the bronchus, with consequent complete interruption of gas flow. However, uncuffed tubes do not have the inflatable cuff that can seal the space between the tube and the bronchus, so the tubetip can be deeply inserted until the gap between the tube and the bronchus is lost. Therefore, the reliability of chest auscultation in determining the proper position of the tracheal tubes is influenced by the Murphy eye, bevel, and cuff. When breath sounds change or disappear during tube advancement, it is necessary to appropriately withdraw the tube, considering the location and size of the Murphy eye, the shape of the bevel, and the presence of the cuff. These maneuvers can prevent inadvertent and unrecognized bronchial intubation during oral and maxillofacial surgery.
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