Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit

Chen, Weiting; Chen, Junbo; Wang, Hehao; Chen, Yingzi

doi:10.1177/0300060519894771

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…The LMA Supreme has been shown to be safe and efficacious. Ultrasound were used for antral diameter measurement, and they show up to be a powerful tool in hands of airway managers, given they offer the opportunity to evaluate the patient for difficult intubation [17], and fasting status [18], they can be used for tube position control [19], to support cricothyrotomy and tracheostomy [20] and also to assess effective positioning of SADs [21].…”

Section: Discussionmentioning

confidence: 99%

Comparison of gastric insufflation using LMA-supreme and I-gel versus tracheal intubation in laparoscopic gynecological surgery by ultrasound: a randomized observational trial

Fang

et al. 2020

BMC Anesthesiol

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Background: The application of bedside ultrasound to evaluate gastric content and volume can assist in determining aspiration risk. Applying positive pressure ventilation via supraglottic airway devices (SAD) can result in a degree of gastric insufflation. This study assessed and compared the antral cross-sectional area (CSA) in patients undergoing laparoscopic gynecological surgery when managed with different SAD. Methods: One hundred American Society of Anesthesiologists I or II female patients were assessed for inclusion in this study and divided into three groups of different ventilation devices. Patients were randomly allocated into three groups to receive LMA-Supreme (Group S), I-gel (Group I) or tracheal tube (Group T). The primary outcome was the antral cross-sectional area and secondary outcomes included haemodynamic parameters and postoperative morbidity such as sore throat, hoarseness, dry throat, nausea and vomiting. Results: The antral CSA was not significantly different among three groups before induction (P = 0.451), after induction (P = 0.456) and at the end of surgery (P = 0.195). The haemodynamic variables were significantly higher in the tracheal tube group than in the LMA-Supreme and I-gel groups after insertion (P < 0.0001) and after removal (P < 0.01). Sore throat was detected in none in the I-gel group compare to two patients (6.7%) in the LMA-Supreme group and fifteen patients (50%) in the tracheal tube group. Hoareness was detected in one (3.3%) in the I-gel group compare to two patients (6.7%) in the LMA-Supreme group and eleven patients (36.7%) in the tracheal tube group. Conclusions: The SADs do not cause obvious gastric insufflation. Thus, LMA-Supreme and I-gel can be widely used as alternative to endotracheal intubation for the short laparoscopic gynecological surgery. Trial registration: This trial was registered at the Chinese Clinical Trial Registry (ChiCTR1800018212, data of registration, September 2018).

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Section: Discussionmentioning

confidence: 99%

Comparison of gastric insufflation using LMA-supreme and I-gel versus tracheal intubation in laparoscopic gynecological surgery by ultrasound: a randomized observational trial

Fang

et al. 2020

BMC Anesthesiol

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“…Naturally intensivists got used to airway ultrasonography and its possibilities. But the research on airway ultrasonography was mainly related to intubation confirmation, but not the position of the ETT [4,5,6]. There were proposals on the position identification based on indirect methods like presence of lung sliding in both lungs [7].…”

Section: Resultsmentioning

confidence: 99%

A Randomised Control Study Comparing Ultrasonography with Standard Clinical Methods in Assessing Endotracheal Tube Tip Positioning

Sreedevi,

Neethu,

Anjali

et al. 2024

The Journal of Critical Care Medicine

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Introduction Airway ultrasound has been increasingly used in correct positioning of endotracheal tube. We hypothesize that a safe distance between endotracheal tube tip and carina can be achieved with the aid of ultrasound. Aim of the study Our primary objective was to determine whether ultrasound guided visualisation of proximal end of endotracheal tube cuff is better when compared to conventional method in optimal positioning of tube tip. The secondary objective was to find the optimal endotracheal tube position at the level of incisors in adult Indian population. Materials and Methods There were 25 patients each in the conventional group and the ultrasound group. Conventional method includes auscultation and end tidal capnography. In the ultrasound group the upper end of the endotracheal tube cuff was positioned with an intent to provide 4 cm distance from the tube tip to the carina. X ray was used in both groups for confirmation of tip position and comparison between the two groups. Further repositioning of the tube was done if indicated and the mean length of the tube at incisors was then measured. Results After x ray confirmation, endotracheal tube repositioning was required in 24% of patients in the USG group and 40 % of patients in the conventional group. However, this result was not found to be statistically significant (p = 0.364). The endotracheal tube length at the level of teeth was 19.4 ± 1.35 cm among females and 20.95 ± 1.37 cm among males. Conclusions Ultrasonography is a reliable method to determine ETT position in the trachea. There was no statistically significant difference when compared to the conventional method. The average length of ETT at the level of incisors was 19.5 cm for females and 21 cm for males.

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“…Tracheal intubation is the main treatment measure for patients with respiratory failure or decreased airway protection in intensive care unit (ICU) [1,2] . An ICU survey study collected from all hospitals in Scotland showed that the incidence of ICU intubation was as high as 70 % [3] .…”

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confidence: 99%

The Effect of Programmed Analgesia and Sedation Combined with Nursing Intervention on Weaning Extubation of Intensive Care Unit Patients

Li¹,

He²,

Yu³

et al. 2021

ijps

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To explore the effect of programmed sedation and analgesia combined with nursing intervention on weaning and extubation of patients with tracheal intubation. 128 patients who underwent tracheal intubation in our hospital from January 2020 to March 2021 were randomly divided into two groups. The control group received routine intensive care intervention, used and adjusted analgesic and sedative drugs according to the doctor's instructions. The intervention group was evaluated and monitored for programmed sedation and analgesia based on the control group. The mechanical ventilation, with tube and intensive care unit hospitalization time, delirium, unplanned extubation, ventilator-associated pneumonia and deep vein thrombosis were compared between the two groups. The incidence of adverse events, nursing satisfaction and the dosage of analgesic and sedative drugs were evaluated. The mechanical ventilation, with tube and intensive care unit hospitalization time were significantly shorter in intervention group (p<0.05). The incidence of adverse events such as delirium, unplanned extubation, ventilator-associated pneumonia and deep vein thrombosis in the intervention group was significantly lower than that in the control group (p<0.05), nursing satisfaction has also increased significantly. Program analgesia and sedation combined care for intensive care unit patients with tracheal intubation can improve the clinical efficacy, shorten the time of weaning extubation and intensive care unit stay, reduce the amount of sedatives, reduce the incidence of related adverse reactions and improve nursing satisfaction.

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Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit

Cited by 5 publications

References 29 publications

Comparison of gastric insufflation using LMA-supreme and I-gel versus tracheal intubation in laparoscopic gynecological surgery by ultrasound: a randomized observational trial

Comparison of gastric insufflation using LMA-supreme and I-gel versus tracheal intubation in laparoscopic gynecological surgery by ultrasound: a randomized observational trial

A Randomised Control Study Comparing Ultrasonography with Standard Clinical Methods in Assessing Endotracheal Tube Tip Positioning

The Effect of Programmed Analgesia and Sedation Combined with Nursing Intervention on Weaning Extubation of Intensive Care Unit Patients

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