Assessment of the proper depth of endotracheal tube placement with the Trachlight.

Study Objective: To test the hypothesis that the correct depth of the endotracheal tube can be confirmed by transillumination method using the Trachlight device, which is a newly introduced lighted stylet for guided, blind tracheal intubation.

Design: Prospective, nonrandomized pilot-trial.

Setting: University-affiliated hospital.

Patients: 72 intubated and mechanically ventilated critically ill adult patients.

Interventions: Patients were briefly disconnected from the respirator. The centimeter marks of the Trachlight cather were brought into line with those of the endotracheal tube, resulting in congruence of the bulb of the Trachlight and the tube tip.

Measurements And Main Results: To measure the distance from the tip of the tube to that of the sternal notch, the Trachlight wand was retracted without moving the endotracheal tube until the bright light appeared in the sternal notch. A chest radiograph was taken to measure the distance between the carina and the tip of the tube. The Trachlight showed a distance of 4.0 +/- 1.3 cm from the tip of the tube to the sternal notch. Chest radiography revealed a distance of 3.3 +/- 1.6 cm between the carina and the tip of the tube, so that the calculated distance between sternal notch and carina was 7.3 +/- 1.5 cm.

Conclusion: To achieve proper depth of the endotracheal tube, it is recommended that the tip of the endotracheal tube be placed 3 cm beyond the sternal notch. The Trachlight provides a simple and easy technique to achieve this goal.