Objective To evaluate the accuracy of tracheal ultrasonography for confirming the endotracheal tube placement during patients' intubation. Patients and methods The current study was a prospective, randomized study performed at the ICU of Al-Hussein Hospital, Cairo. Intubated for respiratory failure, cardiac arrest or other medical causes were included in the current study. Real-time tracheal ultrasonography was conducted during intubation with the ultrasound probe placed transversely over the trachea above the suprasternal notch for confirming the tube position, either tracheal or esophageal. The standard method for confirming endotracheal tube placement include clinical evaluation and rapid bronchoscopic confirmation. The main outcomes were the degree of accuracy and timeliness of tracheal ultrasound in confirming endotracheal tube placement. Results Forty patients eligible for endotracheal intubation were randomized in the current study and only four (10%) patients had confirmed esophageal intubations. Our results concluded that tracheal ultrasound had a diagnostic accuracy of 97.5% in the detection of endotracheal tube site. The sensitivity was 97.2%, while the specificity was 100%. Tracheal ultrasound had a positive predictive value of 100%, while the negative predictive value was 80%. The total operating time of ultrasonography was significantly lower than that of bronchoscopy. Conclusion Real-time ultrasound of the trachea is an accurate, feasible, and fast method in confirming endotracheal tube placement.
Introduction: Acute Respiratory Distress and/or Failure (ARF), is a common and serious presentation of patients admitted to intensive care unit (ICU) and traditional diagnosis has a low accuracy except CT chest which may inappropriate to all patient. Bedside ultrasound (US) is now emerging as a valuable tool in dynamic assessment of lungs, heart, vessels and hemodynamic status. Aim of the work: Our aim in this study was to evaluate the diagnostic utility of combined cardiac and thoracic critical care ultrasonography in identifying causes of Acute Respiratory Distress and/or Failure in the early course of critical illness. Patients and method: This prospective observational study was conducted on adult patient admitted to Medical Intensive Care Unit (MICU), Department of Internal medicine, Al Hussein university hospital, Al Azhar University. All included patients underwent bedside CPUS including lung ultrasound (US) and transthoracic echocardiography plus targeted venous US by single investigator, blinded to clinical data. The US diagnosis of ARF etiology was shared with treating intensivist. Initial clinicaldiagnosis (ICD) of each patient were compared with post US clinical diagnosis.
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