This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Howes, D. W. Articles by Pickett, W. Search for Related Content PubMed PubMed Citation Articles by Howes, D. W. Articles by Pickett, W.

Colorimetric carbon dioxide detector to determine accidental tracheal feeding tube placement

[Un détecteur colorimétrique de gaz carbonique pour déterminer la mise en place endotrachéale accidentelle d’un tube d’alimentation]

Daniel W. Howes, MD FRCPC^*, Eric S. Shelley, MD FRCPC and William Pickett, PhD^*,

^* From the Departments of Emergency Medicine, and
Community Health and Epidemiology,* Queen’s University, Kingston Ontario, Canada.

Address correspondence to: Dr. D. W. Howes, Empire 3, Department of Emergency Medicine, Kingston General Hospital, 76 Stuart St., Kingston, Ontario K7L 2V7, Canada. Phone: 613-549-6666 ext. 6367; Fax: 613-548-1374; E-mail: danielwilliamhowes{at}hotmail.com

Purpose: To determine the accuracy of colorimetric CO₂ detection compared to the reference standard two-step radiological confirmation of feeding tube position.

Methods: A prospective study was conducted with patients presenting to a 21-bed medical-surgical intensive care unit. An adapter was developed using an endotracheal tube adapter to connect a colorimetric CO₂ detector to a feeding tube in an airtight manner. In part I of the study a feeding tube connected to the colorimeter was inserted into the endotracheal tubes of ten ventilated patients to test the device’s ability to detect tracheal placement. In part II patients undergoing feeding tube insertion had tube position confirmed with the colorimeter as well as the reference standard two-step x-ray.

Results: In phase I the colorimeter correctly identified tracheal placement in all ten patients. In phase II 93/100 procedures ultimately were eligible; the colorimeter had a sensitivity of 0.88 (95% confidence interval: 0.65–1.00) and specificity of 0.99 (0.97–1.00). The device missed one of the eight tracheal placements. Agreement between the colorimeter and two-step x-ray interpretations was excellent (Kappa 0.86; standard error 0.10).

Conclusion: We describe a novel, convenient method to confirm esophageal feeding tube placement. The device is easily assembled and inexpensive, but should not be reused. Colorimetric determination of tracheal feeding tube placement with this device has excellent agreement with the reference standard two-step radiological technique.

This article has been cited by other articles:

				V. Munera-Seeley, J. B. Ochoa, N. Brown, A. Bayless, M. I. T. D. Correia, J. Bryk, and M. Zenati Use of a Colorimetric Carbon Dioxide Sensor for Nasoenteric Feeding Tube Placement in Critical Care Patients Compared With Clinical Methods and Radiography Nutr Clin Pract, June 1, 2008; 23(3): 318 - 321. [Abstract] [Full Text] [PDF]

				S. Roberts, P. Echeverria, and S. A. Gabriel Devices and Techniques for Bedside Enteral Feeding Tube Placement Nutr Clin Pract, August 1, 2007; 22(4): 412 - 420. [Abstract] [Full Text] [PDF]

				J. E. de Aguilar-Nascimento and K. A. Kudsk Clinical Costs of Feeding Tube Placement JPEN J Parenter Enteral Nutr, July 1, 2007; 31(4): 269 - 273. [Abstract] [Full Text] [PDF]