• G Baigel and J Safranski.
• Kettering General Hospital, Kettering, UK. garyleah@optusner.com.au
• Eur J Anaesthesiol. 2003 Jun 1;20(6):475-7.

Background And ObjectiveAdvancing an uncut endotracheal tube into the right main bronchus produces unilateral breath sounds. We wanted to test the validity of using this method to distinguish oesophageal from tracheal intubation.MethodsForty-two patients were randomized into two groups. The first group was randomized to receive an endotracheal tube that was advanced into the right main bronchus. The second group of patients had their tracheas intubated as normal and then a second endotracheal tube was placed in the oesophagus. Blinded observers were then asked to decide by auscultation if the patients had unilateral breath sounds or not and if they were bronchial and therefore to decide if endotracheal intubation had occurred.ResultsNinety-one per cent of patients (95% CI 0.71-0.99) intubated in the right main bronchus were correctly identified by unilateral breath sounds confirming the usefulness of this test.ConclusionsAdvancing an endotracheal tube into the right main bronchus and auscultation of unilateral breath sounds is a useful way of confirming tracheal intubation.

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