Accuracy of a Novel Ultrasound Technique for Confirmation of Endotracheal Intubation by Expert and Novice Emergency Physicians

Gottlieb, Michael; Bailitz, John; Christian, Errick; Russell, Frances M.; Ehrman, Robert R.; Khishfe, Basem F.; Kogan, Alexander; Ross, Christopher A.

doi:10.5811/westjem.22550.9.22550

Cited by 42 publications

(30 citation statements)

References 16 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The airway cast was produced using a negative-pressure chamber that facilitated passive passage of silicone into the airways and avoided airway distension (26). Current use of airway ultrasound is limited to a few indications, such as percutaneous tracheostomy (27) and confirmation of endotracheal position during intubation (28). Our findings extend previous use of tracheal ultrasound in lambs to suggest a role for tracheal ultrasound in the evaluation of tracheomalacia in human newborns (29).…”

Section: Discussionsupporting

confidence: 76%

Effect of Prenatal versus Postnatal Vitamin D Deficiency on Pulmonary Structure and Function in Mice

Saadoon¹,

Ambalavanan²,

Zinn

et al. 2017

Am J Respir Cell Mol Biol

View full text Add to dashboard Cite

Epidemiologic studies have linked gestational vitamin D deficiency to respiratory diseases, although mechanisms have not been defined. We hypothesized that antenatal vitamin D deficiency would impair airway development and alveolarization in a mouse model. We studied the effect of antenatal vitamin D deficiency by inducing it in pregnant mice and then compared lung development and function in their offspring to littermate controls. Postnatal vitamin D deficiency and sufficiency models from each group were also studied. We developed a novel tracheal ultrasound imaging technique to measure tracheal diameter in vivo. Histological analysis estimated tracheal cartilage total area and thickness. We found that vitamin D-deficient pups had reduced tracheal diameter with decreased tracheal cartilage minimal width. Vitamin D deficiency increased airway resistance and reduced lung compliance, and led to alveolar simplification. Postnatal vitamin D supplementation improved lung function and radial alveolar count, a parameter of alveolar development, but did not correct tracheal narrowing. We conclude that antenatal vitamin D deficiency impairs airway and alveolar development and limits lung function. Reduced tracheal diameter, cartilage irregularity, and alveolar simplification in vitamin D-deficient mice may contribute to increased airways resistance and diminished lung compliance. Vitamin D supplementation after birth improved lung function and, potentially, alveolar simplification, but did not improve defective tracheal structure. This mouse model offers insight into the mechanisms of vitamin D deficiency-associated lung disease and provides an in vivo model for investigating preclinical preventive and therapeutic strategies. Clinical RelevanceThis murine investigation details structural and physiologic aberrances resulting from prenatal and postnatal vitamin D deficiency. In addition to modeling consequences on lung development, our findings emphasize differential benefit of prenatal versus postnatal vitamin D supplementation. These data provide mechanistic insight into clinical consequences of vitamin D deficiency-induced lung disease and the utility of a mouse model to test preventive and therapeutic interventions.

show abstract

Section: Discussionsupporting

confidence: 76%

Effect of Prenatal versus Postnatal Vitamin D Deficiency on Pulmonary Structure and Function in Mice

Saadoon¹,

Ambalavanan²,

Zinn

et al. 2017

Am J Respir Cell Mol Biol

View full text Add to dashboard Cite

show abstract

“…We were able to correctly identify this phenomenon once the US transducer was moved to the contralateral side. A novel technique proposed by Gottlieb et al used 4 steps to confirm ETT placement in cadavers. The technique involved scanning each side of the neck until the location of the tube was positively identified via a “tube‐sliding” artifact and achieved sensitivity and specificity of 96% and 100%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Real‐time Tracheal Ultrasound for the Confirmation of Endotracheal Intubations in the Intensive Care Unit: An Observational Study

Arya

Schrift

Choe

et al. 2018

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

“…Several prospective studies on human and cadaveric models evaluated the sensitivity and specificity of US confirmation of tube placement in the trachea. [30][31][32][33][34][35][36][37][38] In a meta-analysis of 969 intubations performed in emergency and elective situations, Das et al showed that transtracheal ultrasonography's pooled sensitivity and specificity were 0.98 (95% CI, 0.97 to 0.99) and 0.98 (95% CI, 0.95 to 0.99), respectively. 11 In emergency scenarios, transtracheal US showed an aggregate sensitivity and specificity of 0.98 (95% CI, 0.97 to 0.99) and 0.94 (95% CI, 0.86 to 0.98), respectively.…”

Section: Confirmation Of Tracheal Intubationmentioning

confidence: 99%

Point-of-care ultrasound (POCUS) of the upper airway

You-Ten

Siddiqui

Teoh³

et al. 2018

Can J Anesth/J Can Anesth

101

View full text Add to dashboard Cite

Airway management is a critical skill in the practice of several medical specialities including anesthesia, emergency medicine, and critical care. Over the years mounting evidence has showed an increasing role of ultrasound (US) in airway management. The objective of this narrative review is to provide an overview of the indications for point-of-care ultrasound (POCUS) of the upper airway. The use of US to guide and assist clinical airway management has potential benefits for both provider and patient. Ultrasound can be utilized to determine airway size and predict the appropriate diameter of single-lumen endotracheal tubes (ETTs), double-lumen ETTs, and tracheostomy tubes. Ultrasonography can differentiate tracheal, esophageal, and endobronchial intubation. Ultrasonography of the neck can accurately localize the cricothyroid membrane for emergency airway access and similarly identify tracheal rings for US-guided tracheostomy. In addition, US can identify vocal cord dysfunction and pathology before induction of anesthesia. A rapidly growing body of evidence showing ultrasonography used in conjunction with hands-on management of the airway may benefit patient care. Increasing awareness and use of POCUS for many indications have resulted in technologic advancements and increased accessibility and portability. Upper airway POCUS has the potential to become the first-line non-invasive adjunct assessment tool in airway management.

show abstract

Accuracy of a Novel Ultrasound Technique for Confirmation of Endotracheal Intubation by Expert and Novice Emergency Physicians

Cited by 42 publications

References 16 publications

Effect of Prenatal versus Postnatal Vitamin D Deficiency on Pulmonary Structure and Function in Mice

Effect of Prenatal versus Postnatal Vitamin D Deficiency on Pulmonary Structure and Function in Mice

Real‐time Tracheal Ultrasound for the Confirmation of Endotracheal Intubations in the Intensive Care Unit: An Observational Study

Point-of-care ultrasound (POCUS) of the upper airway

Contact Info

Product

Resources

About