Electromyography as a new means of navigation during endotracheal intubation

Abstract

This study tested a method of using rapid analysis of electromyographic response patterns to electrical stimulation to enable real-time navigation during endotracheal intubation. An electromyographic response detection device was constructed and integrated into a standard endotracheal tube. The rebound rates of the response voltages were measured in the trachea and oesophagus after stimulation in an acute study performed in three freshly euthanized male Suffolk sheep. In a blind study, a physician attempted to identify the tissue type solely from the electrical response signals. In the acute study, the observed rebound rate was found to be significantly faster in tracheal tissue (2.21 × 10⁻³ V s⁻¹) than in oesophageal tissue (3.45 × 10⁻² V s⁻¹; p = 0.000 05). In the blind study, the physician correctly determined the oesophagus response rate seven out of eight times and the tracheal rate eight out of nine times. These results suggest that electromyographic responses can be used to accurately differentiate tracheal from oesophageal tissue during ETT insertion, thus offering a valuable new means of enhancing patient safety.

• Oesophagus
• Intubation
• Intratracheal
• Trachea

Acknowledgements

Stephen N. Palmer, PhD, ELS, and Sally P. Timko, BA, contributed to the editing of the manuscript. Presented at the AHA Resuscitation Conference, 3–7 November 2012, Los Angeles, CA.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.