ETView tracheoscopic ventilation tube for surveillance after tube position in patients undergoing percutaneous nephrolithotomy

Abstract

Background. Tracheal tube (TT) displacement during general anaesthesia may result in life-threatening complications and continuous direct vision of the position of the tube may enable safer management. The ETView tracheoscopic ventilation tube (TVT™) is a single-use TT incorporating a video camera and a light source in its tip. The view from the tip appears continuously on a portable monitor in the anaesthetist's vicinity. This study was designed to test the ETView TVT™ in monitoring the TT position during general anaesthesia. Methods. In this prospective study, the ETView TVT™ was used to ventilate the lungs of 30 adult patients undergoing percutaneous nephrolithotomy (PCNL), which required changing patient position three times. During surgery, the anaesthetist followed the carinal view on the ETView TVT™ portable monitor. Tube movement within 1 cm was recorded, as was the need for repositioning of the tube when the carina was not seen on the camera monitor. Results. During anaesthesia, tiny movements synchronous with heart beats and lung ventilation were observed. Tube movement of 1 cm was detected in eight (26%) patients. In two (7%) patients, the carina was no longer viewed after moving to the lithotomy position and the tube was repositioned. None of the events was associated with changes in oxygen saturation, end-tidal CO 2, or airway pressure. Conclusions. We found that the ETView TVT™ facilitated surveillance of tube position by providing a clear high-quality view of the carina, throughout PCNL with several changes of patient position. © The Author [2010]. Published by Oxford University Press on behalf of The British Journal of Anaesthesia. All rights reserved.