ICU Chest Films > Lines and Tubes > Endotracheal Tubes > Malpositioned Endotracheal Tubes

Malpositioned Endotracheal Tubes

Approximately, 10% of endotracheal tubes are malpositioned. The tube is more likely to enter the right main stem bronchus, due to its more vertical orientation, and reduce left lung ventilation, leading to collapse of the left lung. If the endotracheal tube enters into the bronchus intermedius, the right upper lobe can also collapse.

Right mainstem bronchus intubation (arrow) leading to left lower lobe collapse (arrow heads).

Superiorly placed ET tubes may enter the pharynx or dislodge from the trachea into the esophagus causing filling of the stomach with air and, potentially, reflux of gastric contents. The glottis may also be damaged.