Ultrasound‐guided localisation of the trachea

Orr, J.A.; Stephens, RM; Mitchell, V. M.

doi:10.1111/j.1365-2044.2007.05244.x

Cited by 45 publications

(11 citation statements)

References 8 publications

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“…[1–4] It helps in rapid assessment of the airway anatomy, not only in operation theatre but also in the intensive care unit and emergency department. Various clinical applications of US imaging of the upper airway include identification of endotracheal tube (ETT) placement,[5] guidance of percutaneous tracheostomy[67] and cricothyroidotomy,[8] detection of subglottic stenosis,[9] prediction of difficult intubation[10] and post-extubation stridor,[11] prediction of paediatric ETT[12] and double-lumen tube (DLT) size. [13] This article highlights briefly the review of various published data on the role of US in airway assessment and management.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound of the airway

Kundra¹,

Mishra²,

Ramesh³

2011

Indian J Anaesth

156

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Currently, the role of ultrasound (US) in anaesthesia-related airway assessment and procedural interventions is encouraging, though it is still ill defined. US can visualise anatomical structures in the supraglottic, glottic and subglottic regions. The floor of the mouth can be visualised by both transcutaneous view of the neck and also by transoral or sublinguial views. However, imaging the epiglottis can be challenging as it is suspended in air. US may detect signs suggestive of difficult intubation, but the data are limited. Other possible applications in airway management include confirmation of correct endotracheal tube placement, prediction of post-extubation stridor, evaluation of soft tissue masses in the neck prior to intubation, assessment of subglottic diameter for determination of paediatric endotracheal tube size and percutaneous dilatational tracheostomy. With development of better probes, high-resolution imaging, real-time picture and clinical experience, US has become the potential first-line noninvasive airway assessment tool in anaesthesia and intensive care practice.

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Section: Introductionmentioning

confidence: 99%

Ultrasound of the airway

Kundra¹,

Mishra²,

Ramesh³

2011

Indian J Anaesth

156

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“…Ultrasonography allows reliable [56] and rapid [57] identification of the cricothyroid membrane and trachea prior to both elective trans-tracheal cannulation and emergency cricothyrotomy as demonstrated by an obese patient with Ludwig’s angina, in whom it was not possible to identify the trachea by palpation, whose trachea was eventually located 2 cm lateral to the midline using a portable ultrasound machine [58]. In this way the localisation of the trachea allows the clinician to approach the difficult airway either by placing a trans-tracheal catheter or performing a tracheostomy prior to anaesthesia, or by performing an awake intubation (but with the added safety of having localised the cricothyroid membrane in advance in case the awake intubation fails and emergent transcricoid access becomes necessary).…”

Section: Resultsmentioning

confidence: 99%

Ultrasonography for clinical decision-making and intervention in airway management: from the mouth to the lungs and pleurae

et al. 2014

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ObjectivesTo create a state-of-the-art overview of the new and expanding role of ultrasonography in clinical decision-making, intervention and management of the upper and lower airways, that is clinically relevant, up-to-date and practically useful for clinicians.MethodsThis is a narrative review combined with a structured Medline literature search.ResultsUltrasonography can be utilised to predict airway difficulty during induction of anaesthesia, evaluate if the stomach is empty or possesses gastric content that poses an aspiration risk, localise the essential cricothyroid membrane prior to difficult airway management, perform nerve blocks for awake intubation, confirm tracheal or oesophageal intubation and facilitate localisation of tracheal rings for tracheostomy. Ultrasonography is an excellent diagnostic tool in intraoperative and emergency diagnosis of pneumothorax. It also enables diagnosis and treatment of interstitial syndrome, lung consolidation, atelectasis, pleural effusion and differentiates causes of acute breathlessness during pregnancy. Patient safety can be enhanced by performing procedures under ultrasound guidance, e.g. thoracocentesis, vascular line access and help guide timing of removal of chest tubes by quantification of residual pneumothorax size.ConclusionsUltrasonography used in conjunction with hands-on management of the upper and lower airways has multiple advantages. There is a rapidly growing body of evidence showing its benefits.Teaching Points• Ultrasonography is becoming essential in management of the upper and lower airways.• The tracheal structures can be identified by ultrasonography, even when unidentifiable by palpation.• Ultrasonography is the primary diagnostic approach in suspicion of intraoperative pneumothorax.• Point-of-care ultrasonography of the airways has a steep learning curve.• Lung ultrasonography allows treatment of interstitial syndrome, consolidation, atelectasis and effusion.

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“…2 Chez douze patients devant bénéficier d'une trachéoto-mie percutanée, un repérage échographique en mode B est réalisé avec pour objectif une ponction trachéale entre le premier et le deuxième anneau trachéal. Le matériel utilisé est la machine MicroMaxx de SonoSite (Villebon sur Yvette, France) et une sonde linéaire de 13-6 MHz (sonde utilisée pour le repérage vasculaire et nerveux).…”

Section: Au Rédacteur En Chefunclassified

Technique de repérage échographique du premier anneau trachéal

Arezki¹,

Netcheva²,

Johann³

et al. 2009

Can J Anesth/J Can Anesth

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Au rédacteur en chef,La ponction trachéale lors de la réalisation d'une trachéotomie percutanée est parfois difficile lorsque la palpation ne permet pas le repérage des différents éléments anatomiques.1 C'est un problème qui se pose également lors d'une intubation rétrograde ou une ventilation transtrachéale (jet ventilation) où le succès rapide de la ponction trachéale peut être vital chez le patient qu'on n'arrive ni à intuber et ni à ventiler. 2Chez douze patients devant bénéficier d'une trachéoto-mie percutanée, un repérage échographique en mode B est réalisé avec pour objectif une ponction trachéale entre le premier et le deuxième anneau trachéal. Le matériel utilisé est la machine MicroMaxx de SonoSite (Villebon sur Yvette, France) et une sonde linéaire de 13-6 MHz (sonde utilisée pour le repérage vasculaire et nerveux). La sonde est d'abord placée au contact du cartilage thyroïde, orientée parallèlement à l'axe des deux épaules de façon à avoir une image en coupe transversale. La sonde est ensuite déplacée dans le même plan de haut en bas du cartilage thyroïde du larynx jusqu'en sus-sternal. Une analyse des différentes catégories d'images échographiques obtenues est réalisée tout en s'aidant de la palpation quand celle-ci semble fiable.Dans tous les cas, trois types d'images ont été successivement identifiés et correspondent aux niveaux suivants : 1-Le cartilage thyroïde : aspect en V inversé avec un sommet émoussé suivi d'une ombre acoustique (noir) (Fig. 1). Fig. 1

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Ultrasound‐guided localisation of the trachea

Cited by 45 publications

References 8 publications

Ultrasound of the airway

Ultrasound of the airway

Ultrasonography for clinical decision-making and intervention in airway management: from the mouth to the lungs and pleurae

Technique de repérage échographique du premier anneau trachéal

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