Airway Management in Children: Ultrasonography Assessment of Tracheal Intubation in Real Time?

Marciniak, Bruno; Fayoux, P.; Hébrard, Anne; Krivosic-Horber, R; Engelhardt, Thomas; Bissonnette, Bruno

doi:10.1213/ane.0b013e31819240f5

Cited by 110 publications

(56 citation statements)

References 24 publications

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“…1 In recent years, lung ultrasound has been reported as being useful in detecting bronchial intubation in adults, 2 and it may also be effective for use in children. 3 Herein, we report successful detection of bronchial intubation -not previously identified by auscultation -using lung ultrasound in an infant (aged 14 months; height, 67 cm; weight, 6.9 kg) undergoing pyeloplasty for left ureteropelvic junction obstruction. The infant's medical history included radical surgery for total anomalous pulmonary venous return and home oxygen therapy for tracheomalacia.…”

Section: To the Editormentioning

confidence: 93%

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Using lung ultrasound in an infant to detect bronchial intubation not previously identified by auscultation

Hiruma

Watanabe

Baba

2015

Can J Anesth/J Can Anesth

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Section: To the Editormentioning

confidence: 93%

“…Because desaturation occurs rapidly in children, 5 physicians have limited time to search for the cause. Consequently, in addition to using ultrasound for detecting tracheal intubation 3 and other select lung pathologies, 4 we suggest that it be used to evaluate suspected bronchial intubation.…”

Section: Blue Linementioning

confidence: 99%

Using lung ultrasound in an infant to detect bronchial intubation not previously identified by auscultation

Hiruma

Watanabe

Baba

2015

Can J Anesth/J Can Anesth

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“…An indirect method is by observing bilateral lung sliding with ventilation as the probe is placed in the midaxillary line. Marciniak et al [41] describe some characteristic ultrasonographic findings in the pediatric airway (e.g., shape changes of the glottis as the tracheal tube passes, enhanced posterior shadowing of the trachea, visualization of the vocal cords, and confirmation of bilateral lung movements) that could help during tracheal intubation. Recently, Fiadjoe et al [42] reported an ultrasound-guided tracheal intubation in a 14-monthold baby, using a 15 MHz linear ultrasound probe at the level of the thyrohyoid membrane.…”

Section: Airway Assessmentmentioning

confidence: 99%

Lung Ultrasound in the Critically Ill

Cho

2017

Korean J Crit Care Med

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Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, making it a useful diagnostic and monitoring tool in medicine. Anesthesiologists encounter a variety of emergent situations and may benefit from the application of such a rapid and accurate diagnostic tool in their routine practice. This paper reviews current and potential applications of ultrasound in anesthesiology in order to encourage anesthesiologists to learn and use this useful tool as an adjunct to physical examination. Ultrasound-guided peripheral nerve blockade and vascular access represent the most popular ultrasound applications in anesthesiology. Ultrasound has recently started to substitute for CT scans and fluoroscopy in many pain treatment procedures. Although the application of airway ultrasound is still limited, it has a promising future. Lung ultrasound is a well-established field in point-of-care medicine, and it could have a great impact if utilized in our ORs, as it may help in rapid and accurate diagnosis in many emergent situations. Optic nerve sheath diameter (ONSD) measurement and transcranial color coded duplex (TCCD) are relatively new neuroimaging modalities, which assess intracranial pressure and cerebral blood flow. Gastric ultrasound can be used for assessment of gastric content and diagnosis of full stomach. Focused transthoracic (TTE) and transesophageal (TEE) echocardiography facilitate the assessment of left and right ventricular function, cardiac valve abnormalities, and volume status as well as guiding cardiac resuscitation. Thus, there are multiple potential areas where ultrasound can play a significant role in guiding otherwise blind and invasive interventions, diagnosing critical conditions, and assessing for possible anatomic variations that may lead to plan modification. We suggest that ultrasound training should be part of any anesthesiology training program curriculum.

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“…[1][2][3][4][5][6][7][8] Air transmits the ultrasound beam poorly, leading to an artifact called ''dirty shadowing.'' With or without an ETT in place, the trachea appears as an area of dirty shadowing on a sonogram because it is filled with air.…”

mentioning

confidence: 99%

Inflating the endotracheal tube cuff with saline to confirm correct depth using bedside ultrasonography

Tessaro

Arroyo

Haines

et al. 2015

CJEM

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Although bedside ultrasonography can accurately distinguish esophageal from tracheal intubation, it is not used to establish the correct depth of endotracheal tube insertion. As indirect sonographic markers of endotracheal tube insertion depth have proven unreliable, a method for visual verification of correct tube depth would be ideal. We describe the use of saline to inflate the endotracheal cuff to confirm correct endotracheal tube depth (at the level of the suprasternal notch) by bedside ultrasonography during resuscitation. This rapid technique holds promise during emergency intubation. RÉ SUMÉBien que l'é chographie au chevet des patients permette de distinguer nettement l'intubation oesophagienne de l'intubation endotraché ale, elle n'est toutefois pas utilisé e pour dé terminer si la sonde a é té posé e à la bonne profondeur dans la traché e. Comme on ne peut se fier aux marqueurs é chographiques indirects de vé rification de la profondeur de pé né tration de la sonde endotraché ale, l'idé al serait de procé der par vé rification visuelle. Il sera question ici du gonflement du ballonnet endotraché al avec une solution saline pour confirmer l'introduction de la sonde à la bonne profondeur (à la hauteur de la fourchette sternale) par é chographie au chevet des patients durant les manoeuvres de ré animation. Cette technique rapide se ré vè le prometteuse dans le contexte des intubations d'urgence.

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Airway Management in Children: Ultrasonography Assessment of Tracheal Intubation in Real Time?

Abstract: This study describes characteristic ultrasonographic findings of the pediatric airway during tracheal intubation. It suggests that ultrasonography may be useful for airway management in children.

Cited by 110 publications

References 24 publications

Using lung ultrasound in an infant to detect bronchial intubation not previously identified by auscultation

Using lung ultrasound in an infant to detect bronchial intubation not previously identified by auscultation

Lung Ultrasound in the Critically Ill

Inflating the endotracheal tube cuff with saline to confirm correct depth using bedside ultrasonography

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