Tracheal ultrasonography and ultrasonographic lung sliding for confirming endotracheal tube placement: Speed and Reliability

Karacabey, Sinan; Sanri, Erkman; Gencer, Emin Gokhan; Güneysel, Özlem

doi:10.1016/j.ajem.2016.01.027

Cited by 24 publications

(20 citation statements)

References 16 publications

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“…22 Tracheal ultrasonography compensates for this deficiency without affecting cardiopulmonary resuscitation. However, Karacabey et al 23 showed that the accuracy of tracheal ultrasonography in identifying the ETT position in patients with cardiac arrest was 76.7% because it was affected by cardiopulmonary resuscitation. We also found that some differences influence the results obtained from each method.…”

Section: Discussionmentioning

confidence: 99%

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

Chen

Wang

et al. 2019

J Int Med Res

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Objective Critically ill patients often require emergency endotracheal intubation and mechanical ventilation. When esophageal intubation is not confirmed early, treatment may be delayed, even for life-threatening conditions. We examined the accuracy of bedside real-time airway ultrasonography in confirming the endotracheal tube (ETT) position during emergency endotracheal intubation in patients in the intensive care unit (ICU). Methods This single-center prospective observational study included 118 patients who underwent urgent endotracheal intubation in the ICU of Taizhou Hospital of Integrated Traditional Chinese and Western Medicine. Tracheal ultrasonography was used to confirm the ETT position during endotracheal intubation, after which fiberoptic bronchoscopy was performed. The accuracy of bedside real-time tracheal ultrasonography in determining the ETT position was examined. Results Twelve (10.2%) patients underwent endotracheal intubation. The kappa value was 0.844, indicating perfect consistency between tracheal ultrasonography and fiberoptic bronchoscopy in identifying esophageal intubation. The sensitivity, specificity, and positive and negative predictive values of tracheal ultrasonography in determining the ETT position were 75.0%, 100%, 100%, and 97.2%, respectively. Conclusions Bedside real-time tracheal ultrasonography accurately assesses the ETT position in the ICU and can identify the ETT position during intubation. These findings have important clinical applications and are of great significance for treatment of ICU patients.

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Section: Discussionmentioning

confidence: 99%

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

Chen

Wang

et al. 2019

J Int Med Res

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“…US for ETT placement is especially useful when waveform capnography is not readily available [67] or if a conventional method is misleading, such as colorimetry-verified placement with continued hypoxia. Several authors have shown that US is quicker than conventional methodologies of ETT placement confirmation, demonstrating an average time to confirmation of 5.8 seconds, significantly faster than capnography at 11.8 seconds [68]. We advocate for enhancing testing characteristics by combining visualization of neck airway structures with lung field pleural sliding and respiratory diaphragmatic motion, which can be performed during pulse check.…”

Section: Us For Endotracheal Tube (Ett) Placement Confirmationmentioning

confidence: 96%

Focused Sonography in Cardiac Arrest

Delaney¹,

Flora²,

Ahmad³

2017

Resuscitation Aspects

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Cardiac arrest (CA) is a high mortality event where the ability for clinicians to diagnose etiology and assess for intervention has a direct impact on patient outcomes. Bedside ultrasound (US) has emerged in current literature as a clinical tool to aid clinicians in CA resuscitation, though it remains underutilized. Reversible etiologies that can be efficiently diagnosed with US include tension pneumothorax, hypovolemia, pulmonary embolus with acute cor pulmonale, and cardiac tamponade. Other US findings may provide evidence in regard to prognosis. In this review, we present major applications of US in CA, compare existing protocols, and propose future research needs.

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“…Additionally, several more studies and meta-analyses assessing ultrasound for ETT confirmation made no mention of the lung pulse. [30][31][32][33][34][35][36][37] There were even a few such studies conducted in the prehospital setting. 37,38 Of note, however, a key distinction between prehospital and rapid-sequence intubation in the emergency department is that emergency medical services personnel may not administer pharmacologic paralysis.…”

Section: Inadequate Physician Understanding and Recognition Of The Lumentioning

confidence: 99%

Unmasking the Lung Pulse for Detection of Endobronchial Intubation

Alerhand

Tsung

2020

J of Ultrasound Medicine

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The ultrasound lung pulse for detecting endobronchial intubation was first described in 2003 in the only study to date assessing its accuracy. It refers to rhythmic movement of the visceral pleura along the stationary parietal pleura as cardiac vibrations transmit through a motionless, airless lung. Compared to delayed visualization on chest radiography, this artifact immediately detects physiologic atelectasis. There is a scarcity of studies assessing the lung pulse, while several others that encountered this artifact did not even identify it. The lung pulse is useful for immediate detection of endobronchial intubation, but it remains unrecognized and underused by physicians.

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Tracheal ultrasonography and ultrasonographic lung sliding for confirming endotracheal tube placement: Speed and Reliability

Cited by 24 publications

References 16 publications

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

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

Focused Sonography in Cardiac Arrest

Unmasking the Lung Pulse for Detection of Endobronchial Intubation

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