• Avi Cohen, Laren Tan, Ramiz Fargo, James D Anholm, Chris Gasho, Kashif Yaqub, Sahil Chopra, Jennifer Hansen, Cynthia Huang, Dafne Moretta, Destry Washburn, and H Bryant Nguyen.
• Division of Pulmonary, Critical Care, Hyperbaric and Sleep Medicine, Department of Medicine, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA; Loma Linda University Medical Center, Loma Linda University Health, Loma Linda, CA 92354, USA.
• J Crit Care. 2018 Dec 1; 48: 222-227.

PurposeTo demonstrate that use of a minimally invasive catheter reduces endotracheal tube (ETT) malposition rate after intubation.Materials And MethodsThis study is a multi-center, prospective observational cohort of intubated patients in the medical intensive care unit. The catheter was inserted into the ETT immediately after intubation. The ETT was adjusted accordingly based on qualitative color markers on the catheter. A confirmatory chest radiograph was obtained to determine the ETT position. Malposition of the ETT was defined by the distal ETT not being within 2-5 cm above the carina.ResultsSixty-nine patients were enrolled, age 56.2 ± 19.5 years, body mass index 31.0 ± 13.8 kg/m2. The catheter prompted repositioning of the ETT in 39 (56.5%) patients. Using the catheter, the rate of malposition decreased to 7.2%, with the distal ETT position at 3.7 ± 1.2 cm above the carina. Without the catheter, the ETT malposition rate would have been 39.1%. The time for catheter use and chest radiograph completion at our institutions was 1.7 ± 1.5 and 44.4 ± 36.4 min, respectively.ConclusionsWith use of an ETT positioning catheter after intubation, the ETT malposition rate was reduced by 82%. This catheter-based system was safe, and its use may perhaps decrease the need for the post-intubation chest radiograph.Copyright © 2018 Elsevier Inc. All rights reserved.

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