Ultrasonography Imaging versus Waveform Capnography in Detecting Endotracheal Tube Placement during Intubation at a Tertiary Hospital

IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Ultrasound Pub Date : 2023-11-10 DOI:10.4103/jmu.jmu_98_22

Shirish Shakti Maskay, Ninadini Shrestha, Priska Bastola, Bishwas Pradhan, Anil Shrestha

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引用次数: 0

Abstract

Abstract Background: There is continued research to find new faster, highly accurate, easily accessible, and portable methods of confirming endotracheal tube position during intubation. A newer modality for visualizing endotracheal tube location is transtracheal or transcricothyroid ultrasonography. The aim of this study was to see if ultrasound machine can also be routinely used for the confirmation of endotracheal tube position in operating theaters along with capnograph. Methods: The study was observational and prospective, conducted from January 2017 to July 2017. Study locations were at the Tribhuvan University Teaching Hospital and Manmohan Cardiothoracic Vascular and Transplant Center operating rooms. Sample size taken was 95. Results: In the study, 11 patients had esophageal intubation out of the 95. The accuracy of both ultrasonography and capnography was found to be 96.84%. For ultrasonography, the sensitivity, specificity, along with positive predictive value and negative predictive value were 97.62%, 90.91%, 98.80%, and 83.33%, respectively, while that for capnography were found to be 96.43%, 100%, 100%, and 78.57%, respectively. The kappa value was calculated to be 0.749, which suggested the degree of agreement of result between the methods to be good. Compared to capnography, ultrasonography was found to be significantly faster for the confirmation of endotracheal tube location by 16.36 s (15.70–17.02) ( P = 0.011). Conclusion: Both waveform capnography and ultrasonography were found to be accurate and reliable in confirming endotracheal tube location. The use of ultrasound during intubation can help confirm endotracheal tube location faster and also aid in precision when used along with capnography. Manual bag ventilations are not necessary when confirming endotracheal tube position by ultrasonography and thus may help in preventing aspiration of gastric contents into the lungs of the patient.

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超声成像与波形导管造影在三级医院插管过程中检测气管插管位置的比较

背景:在气管插管过程中，不断有研究寻找新的更快、高精度、易于获取和便携的气管插管位置确认方法。经气管或经甲状腺超声检查是一种较新的观察气管内导管位置的方法。本研究的目的是探讨超声机是否也可以在手术室常规应用于气管插管位置的确认。方法:研究于2017年1月至2017年7月进行观察性和前瞻性研究。研究地点在特里布万大学教学医院和曼莫汉心胸血管和移植中心的手术室。样本量为95。结果:本组95例患者中，11例患者行食管插管。超声和超声检查的准确率均为96.84%。超声检查的敏感性、特异性、阳性预测值和阴性预测值分别为97.62%、90.91%、98.80%和83.33%，而超声检查的敏感性、特异性和阳性预测值分别为96.43%、100%、100%和78.57%。计算kappa值为0.749，说明各方法的结果吻合程度较好。超声对气管内导管位置的确定比超声检查快16.36 s(15.70 ~ 17.02)，差异有统计学意义(P = 0.011)。结论:超声和波形超声对气管插管位置的确定准确可靠。在插管过程中使用超声可以帮助更快地确定气管内管的位置，并且当与导管造影一起使用时也有助于精确定位。在超声检查确认气管内管位置时，不需要手动气囊通气，因此可能有助于防止胃内容物吸入患者肺部。

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来源期刊

Journal of Medical Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

1.30

自引率

9.10%

发文量

审稿时长

10 weeks

期刊介绍： The Journal of Medical Ultrasound is the peer-reviewed publication of the Asian Federation of Societies for Ultrasound in Medicine and Biology, and the Chinese Taipei Society of Ultrasound in Medicine. Its aim is to promote clinical and scientific research in ultrasonography, and to serve as a channel of communication among sonologists, sonographers, and medical ultrasound physicians in the Asia-Pacific region and wider international community. The Journal invites original contributions relating to the clinical and laboratory investigations and applications of ultrasonography.