Comparison of End-tidal Capnography, Chest Auscultation, and Upper Airway Ultrasonography for Rapid Confirmation of Endotracheal Tube Placement by Trainees among Patients Requiring Intubation for General Anesthesia.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL

Annals of African Medicine Pub Date : 2025-08-20 DOI:10.4103/aam.aam_221_24

Vallikanna Subramanian, Julie C R Misquith, Shilpa A Naik, Karl Nicholas Sa Ribeiro

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引用次数: 0

Abstract

Background: Ensuring proper endotracheal tube (ETT) placement is crucial during general anesthesia. Traditional confirmation methods include capnography and chest auscultation, but each has limitations. Ultrasound (USG) offers real-time visualization of ETT placement, potentially improving confirmation speed and accuracy.

Objectives: To compare the feasibility of USG for early detection of esophageal intubation against capnography and chest auscultation in trainees.

Methodology: This comparative observational study assessed the time for ETT placement confirmation using USG, capnography, and chest auscultation in 90 patients undergoing general anesthesia. Patients were divided into three groups: USG confirmation (Group A), capnography confirmation using the first or sixth waveform (Group B), and chest auscultation confirmation (Group C).

Results: Group A had the fastest confirmation time (32.1 s), followed by Group C (bilateral: 46.97 s), and Group B (6th waveform: 48.23 s). Statistically significant differences were observed between Group A and Group B (6th waveform), and Group A and Group C (bilateral). Hemodynamic parameters showed significant changes during and after intubation compared to baseline.

Conclusions: USG emerged as a faster and potentially more reliable method for ETT placement confirmation compared to capnography and chest auscultation. The real-time visualization offered by USG is valuable for novice trainees, enabling rapid confirmation, and potentially improving patient safety by facilitating early detection of misplacement.

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潮末超声、胸部听诊、上呼吸道超声快速确认全麻插管患者气管插管位置的比较

背景：在全身麻醉过程中，确保气管内插管（ETT）的正确放置是至关重要的。传统的确认方法包括血管造影和胸部听诊，但每种方法都有局限性。超声（USG）提供ETT放置的实时可视化，可能提高确认速度和准确性。目的：比较超声心动图与超声心动图、胸部听诊早期发现学员食管插管的可行性。方法：本比较观察性研究评估了90例全身麻醉患者使用超声心动图、超声心动图和胸部听诊确认ETT放置的时间。患者分为三组：超声心动图确认组（A组）、第一或第六次超声心动图确认组（B组）和胸部听诊确认组（C组）。结果：A组确认时间最快（32.1 s），其次为C组（双侧46.97 s）， B组（第6次波形48.23 s）。A组与B组（第6次波形）、A组与C组（双侧波形）比较差异有统计学意义。与基线相比，插管期间和插管后的血流动力学参数发生了显著变化。结论：与血管造影和胸部听诊相比，USG是一种更快、更可靠的ETT放置确认方法。USG提供的实时可视化对新手来说很有价值，可以快速确认，并通过促进早期发现错位，潜在地提高患者的安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of African Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

0.90

自引率

0.00%

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期刊介绍： The Annals of African Medicine is published by the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria and the Annals of African Medicine Society. The Journal is intended to serve as a medium for the publication of research findings in the broad field of Medicine in Africa and other developing countries, and elsewhere which have relevance to Africa. It will serve as a source of information on the state of the art of Medicine in Africa, for continuing education for doctors in Africa and other developing countries, and also for the publication of meetings and conferences. The journal will publish articles I any field of Medicine and other fields which have relevance or implications for Medicine.