Reliability of ultrasound in confirming endotracheal tube placement as a new and fast tool
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Reliability of ultrasound in confirming endotracheal tube placement as a new and fast tool Mohammad W.S. Moghawri, Niveen E. Zayed, Dalia A. Ibrahim Background Chest ultrasound has been an important tool for the diagnosis of many chest diseases, and, recently, it became an important tool for confirmation of the site of endotracheal tube placement. In our study, we used the ultrasound for this confirmation and compared this with capnography and clinical examination as gold standards and also with chest radiograph.
three modalities. The time taken to confirm tube placement with ultrasonography was 7.7±1.6 s compared with waveform capnography, clinical examination, and chest radiograph, which were18.8±2.6, 26.1±3.4, and 73.6±7.7 s, respectively. The time taken by ultrasonography was significantly less. Conclusion Sonar-confirmed endotracheal intubation saves time and life, particularly in patients with low pulmonary blood flow in comparison with other traditional methods of confirmation. Egypt J Bronchol 2019 13:684–689 © 2020 Egyptian Journal of Bronchology
Patients and methods This is a cross-sectional study conducted in our chest ICU from January 2019 to August 2019. We included 30 chronic obstructive pulmonary disease patients with acute respiratory failure who needed endotracheal intubation according to the protocols. Ultrasound was used to identify and confirm endotracheal tube placement simultaneously with a quantitative waveform capnography (end-tidal carbon dioxide), clinical methods, and chest radiograph. Confirmation of tube placement and time taken for the confirmation were noted by our staff.
Egyptian Journal of Bronchology 2019 13:684–689
Results Of the 30 intubation attempts, six (20%) had esophageal intubations. The sensitivity and specificity of diagnosis using ultrasonography were 95.8 and 93.3%, respectively. This was statistically comparable with the other
Received: 26 September 2019 Accepted: 24 November 2019 Published: 21 January 2020
Keywords: capnography, chest ICU, intubation, ultrasonography Department of Chest, Zagazig University, Zagazig, Egypt Correspondence to Niveen E. Zayed, MD, Department of Chest, Zagazig University, Zagazig 44519, Egypt. Tel: +20 102 483 1444; e-mail: [email protected]
Introduction Chest ultrasound has become widely used and easy with high diagnostic yield in many critical care areas and chest departments. The European Resuscitation Council 2010 in the scope of the International Liaison Committee on Resuscitation Consensus on Science and Treatment Recommendations recognized the value of chest ultrasound as an adjuvant for the diagnosis and treatment of the possible reversible causes of cardiac arrest [1,2]. Using ultrasonography to confirm the positioning of the endotracheal tube (ETT) is advisable owing to many causes, as it is portable, bedside and can be repeated many times, cost-effective, noninvasive and painless method. Direct tracheal ultrasound demonstrates larynx anatomy and tracheal anatomy independent of patient physiology and is not influe
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