The addition of a brief ultrasound examination to clinical assessment increases the ability to confirm placement of double-lumen endotracheal tubes

Šustić, Alan; Protić, Alen; Cicvarić, Tedi; Župan, Željko

doi:10.1016/j.jclinane.2009.07.010

Cited by 67 publications

(39 citation statements)

References 15 publications

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“…[5614] The use of ultrasound becomes important during cardiopulmonary resuscitation as capnography is less reliable in confirmation of endotracheal intubation in this situation.…”

Section: Discussionmentioning

confidence: 99%

“…[67141516171819] It reduces the incidence of unrecognised oesophageal intubation and prevents morbidity and mortality. However, this technique may be of limited use in patients with large swellings of anterior neck, gross tracheal shift, short and stout neck, especially in the presence of extreme obesity.…”

Section: Discussionmentioning

confidence: 99%

“…[6]), with 95% confidence and 20% allowable error, the minimum sample size was calculated as 40. Chi-square test was used to compare the gender and the presence or absence of breath sounds and the lung sliding in both the groups.…”

Section: Methodsmentioning

confidence: 99%

“…Obese patients usually yield confusing or misleading auscultatory findings as the sound waves have to traverse large amount of tissues which represent a significant barrier. Ultrasonographic (USG) imaging of the sliding lung sign has been shown to be an accurate indicator of endotracheal intubation,[34567] and hence can be used as an additional measure for confirming proper tracheal placement of the endotracheal tube.…”

Section: Introductionmentioning

confidence: 99%

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Rapidity and efficacy of ultrasonographic sliding lung sign and auscultation in confirming endotracheal intubation in overweight and obese patients

et al. 2017

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“…[5614] The use of ultrasound becomes important during cardiopulmonary resuscitation as capnography is less reliable in confirmation of endotracheal intubation in this situation.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Rapidity and efficacy of ultrasonographic sliding lung sign and auscultation in confirming endotracheal intubation in overweight and obese patients

et al. 2017

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“…Passing of the tracheal tube is visible in all children and characterised by the widening of the vocal cords when the transducer is placed at the level of the glottis [75]. Ultrasonography is also useful in confirming the correct position of a double-lumen tube [52, 76]. …”

Section: Resultsmentioning

confidence: 99%

Ultrasonography for clinical decision-making and intervention in airway management: from the mouth to the lungs and pleurae

et al. 2014

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ObjectivesTo create a state-of-the-art overview of the new and expanding role of ultrasonography in clinical decision-making, intervention and management of the upper and lower airways, that is clinically relevant, up-to-date and practically useful for clinicians.MethodsThis is a narrative review combined with a structured Medline literature search.ResultsUltrasonography can be utilised to predict airway difficulty during induction of anaesthesia, evaluate if the stomach is empty or possesses gastric content that poses an aspiration risk, localise the essential cricothyroid membrane prior to difficult airway management, perform nerve blocks for awake intubation, confirm tracheal or oesophageal intubation and facilitate localisation of tracheal rings for tracheostomy. Ultrasonography is an excellent diagnostic tool in intraoperative and emergency diagnosis of pneumothorax. It also enables diagnosis and treatment of interstitial syndrome, lung consolidation, atelectasis, pleural effusion and differentiates causes of acute breathlessness during pregnancy. Patient safety can be enhanced by performing procedures under ultrasound guidance, e.g. thoracocentesis, vascular line access and help guide timing of removal of chest tubes by quantification of residual pneumothorax size.ConclusionsUltrasonography used in conjunction with hands-on management of the upper and lower airways has multiple advantages. There is a rapidly growing body of evidence showing its benefits.Teaching Points• Ultrasonography is becoming essential in management of the upper and lower airways.• The tracheal structures can be identified by ultrasonography, even when unidentifiable by palpation.• Ultrasonography is the primary diagnostic approach in suspicion of intraoperative pneumothorax.• Point-of-care ultrasonography of the airways has a steep learning curve.• Lung ultrasonography allows treatment of interstitial syndrome, consolidation, atelectasis and effusion.

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Tracheal Ultrasound for the Accurate Confirmation of the Endotracheal Tube Position in Obese Patients

Men

Yan

2019

J of Ultrasound Medicine

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Objectives Obesity is a serious disorder that may lead to numerous difficulties in endotracheal tube (ETT) management. This study investigated the potential of tracheal ultrasound (TUS) for the accurate confirmation of the ETT position in obese patients. Methods A total of 68 obese patients undergoing tracheal intubation were enrolled in this study from January 2017 to June 2018. All patients received auscultation and TUS to evaluate the ETT position, which was ultimately verified by bronchoscopy. A correct position of the ETT was defined as placement at the trachea, whereas placement at the right/left main bronchus was classified as an incorrect position. Results We found 58 correct placements of the ETT at the trachea, 8 incorrect placements at the right main bronchus, and 2 incorrect placements at the left main bronchus. Compared with auscultation, TUS showed higher accuracy (85.29% versus 67.65%; P = .005), sensitivity (84.48% versus 67.24%; P = .005), and specificity (90.00% versus 70.00%; P < .001), as well as lower rates of false‐positive (10.00% versus 30.00%; P < .001) and false‐negative (15.52% versus 32.76%; P = .005) results for detecting the correct placement of the ETT, defined as placement at the trachea. Conclusions Tracheal ultrasound is highly sensitive and specific in confirming the ETT position in obese patients.

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The addition of a brief ultrasound examination to clinical assessment increases the ability to confirm placement of double-lumen endotracheal tubes

Cited by 67 publications

References 15 publications

Rapidity and efficacy of ultrasonographic sliding lung sign and auscultation in confirming endotracheal intubation in overweight and obese patients

Rapidity and efficacy of ultrasonographic sliding lung sign and auscultation in confirming endotracheal intubation in overweight and obese patients

Ultrasonography for clinical decision-making and intervention in airway management: from the mouth to the lungs and pleurae

Tracheal Ultrasound for the Accurate Confirmation of the Endotracheal Tube Position in Obese Patients

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