Acute cardiac care & resuscitationCohort study
Recognition of esophageal intubation in Dutch prehospital emergency medical services using capnography analysis: a retrospective cohort study
- retrospective cohort study
Authors' conclusion
This study uses analysis of waveform morphology to distinguish esophageal from tracheal intubation. While etCO2 values can appear numerically similar, the waveform morphology differs significantly. These findings represent an important first step toward developing automated tools for detecting inadequate ventilation by esophageal intubation. Larger datasets and prospective validation are needed before clinical implementation.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) patients with unrecognized esophageal intubation after ground EMS airway management, Rotterdam Helicopter Emergency Medical Service (HEMS) database, January 2015 to November 2024OHCA cases in the region of interest with usable capnography, of 92 esophageal intubations among 5830 cases with intubation prior or during HEMS deployment
- Participants
- 14 participants
- Exposure
- esophageal and tracheal intubations
Main finding
As reported in the abstract
Maximal CO2
Observational data: associations, not effects.
Further findings
CO2 trend in esophageal intubations
- Downward trend approaching near-zero values of CO2 within eight ventilations
Corrected area under the curve and upslope
- Significant differences in median corrected area under the curve and median upslope between esophageal and tracheal intubations
Original publication
Recognition of esophageal intubation in Dutch prehospital emergency medical services using capnography analysis: a retrospective cohort study. Resuscitation. Published 16 January 2026. doi:10.1016/j.resuscitation.2026.110969
Summarised from the published abstract; every number is checked against it