Reliability of capnography in identifying esophageal intubation with carbonated beverage or antacid in the stomach

S. T. Sum Ping, M. P. Mehta, T. Symreng

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

To evaluate the reliability of capnography in identifying esophageal intubation in the presence of a carbonated beverage in the stomach, we first investigated the amount of CO2 released from different carbonated beverages and antacids in a simulated stomach; next we measured the end-expired CO2 level during esophageal ventilation with a carbonated beverage in the stomachs of six swine. CO2 levels of approximately 20% were consistently observed in all carbonated beverages. The CO2 levels obtained with sodium bicarbonate, Maalox, and sodium citrate were 19.3%, 2.0%, and 0%, respectively. CO2 waveforms were observed during esophageal ventilation in five of six animals after intragastric administration of a carbonated beverage. An end-expired CO2 level of 2.5% or more was observed in two swine. The highest end-expired CO2, level measured was 5.3%. We conclude that although capnography is convenient and effective, it lacks all the attributes of an ideal monitor for detecting esophageal intubation.

Original languageEnglish (US)
Pages (from-to)333-337
Number of pages5
JournalAnesthesia and analgesia
Volume73
Issue number3
StatePublished - Jan 1 1991

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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