Tubusposition

Tubusposition is a medical term referring to the location of an airway tube (endotracheal or tracheal tube) within the respiratory tract after intubation. Accurate positioning is critical to ensure effective ventilation, prevent aspiration, avoid injury, and reduce the risk of one-lung ventilation or accidental extubation.

In adults the ideal tube tip typically lies about 2–5 cm above the carina, with common insertion depth measurements around 21 cm at the teeth for women and 23 cm for men as rough guides. Pediatric targets differ because of shorter airway length; small changes in depth can cause mainstem intubation or extubation, so age- or size-adjusted guidelines and careful confirmation are required.

Verification of Tubusposition uses a combination of clinical and instrumental methods. End-tidal CO2 confirms tracheal (versus esophageal) placement, while chest radiography is commonly used to document tip-to-carina distance. Fiberoptic bronchoscopy provides direct visualization and is the most precise method. Auscultation and symmetric chest rise are supportive but less reliable.

Malposition can be low (endobronchial, usually right mainstem), causing unilateral ventilation, or high, risking dislodgement and inadequate airway protection. Displacement can occur with patient movement, transport, or changes in neck position. Regular reassessment and secure fixation are standard practice to maintain a safe Tubusposition in operative, emergency, and intensive care settings.