Use of Bedside Ultrasonography for Endotracheal Tube Placement in Pediatric Patients: A Feasibility Study

Galicinao, Jeanette; Bush, Andrew; Godambe, Sandip A.

doi:10.1542/peds.2006-2959

Cited by 125 publications

(88 citation statements)

References 19 publications

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“…Similarly, Milling et al [12] shows the benefit of BUS in detecting esophageal intubations. Galicinao et al [13] show that a comet sign or a set of parallel lines on transverse and longitudinal views, respectively, allow visualization of the ETT in all cases, as had been previously described by Drescher et al [14]. …”

Section: Discussionmentioning

confidence: 85%

Ultrasound Confirmation of Endotracheal Tube Position in Neonates

Dennington¹,

Vali²,

Finer³

et al. 2012

Neonatology

101

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Background: The placement of the endotracheal tube (ETT) in neonates is a challenging procedure that currently requires timely confirmation of tip placement by radiographic imaging. Objective: We sought to determine if bedside ultrasound (US) could demonstrate ETT tip location in preterm and term newborns and offer a quick alternative method of ETT positioning. Methods: We conducted a prospective pilot study of 30 newborns admitted to the UC San Diego Medical Center who had their ETT placement confirmed by chest radiographs. After a radiograph, each infant had a US exam with a 13-MHz linear transducer on a portable US machine. To assist localization, gentle longitudinal movement of the ETT of less than 0.5 cm was performed. Measurements from the tip of the ETT tip to the carina were made on chest radiograph and midsagittal US images. Results: Study infants had a mean gestational age of 30.2 ± 4.9 (SD) weeks and mean birth weight of 1,595.2 ± 862 g. US images were taken a mean 2.9 ± 2.2 h after radiographs. Data from 2 infants were excluded for poor radiograph image quality and extreme outlier values. The ETT was visualized by US in all newborns examined. We observed a good correlation between ETT tip-to-carina distance on US and radiograph (r² = 0.68) with minimal bias. Each study took less than 5 min to obtain without any clinical deterioration. Conclusions: Bedside US can visualize the anatomic position of the ETT position in preterm and term infants but further validation is required before routine clinical implementation.

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Section: Discussionmentioning

confidence: 85%

Ultrasound Confirmation of Endotracheal Tube Position in Neonates

Dennington¹,

Vali²,

Finer³

et al. 2012

Neonatology

101

View full text Add to dashboard Cite

show abstract

“…This might lead to unexpected misplacement of ETT and potential hazard. Sonogram is a rapid and accurate tool to ascertain the ETT tip position [19]; however, it is operatordependent, that may produce a false confirmatory images of esophageal intubation by immature operator, and not so conveniently available [20]. Using the NTL as a predictor of the optimal ETT depth is a fast, easy and safe choice.…”

Section: Discussionmentioning

confidence: 99%

Utilizing Nasal-Tragus Length to Estimate Optimal Endotracheal Tube Depth for Neonates in Taiwan

2010

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“…These lines represent the outer and inner surfaces of the anterior aspect of the ETT. 6 The saline within the cuff acted as an acoustic window allowing visualization of the tube, which had not been possible when the cuff was filled with air. When the saline was evacuated, these parallel lines disappeared.…”

Section: Case Reportmentioning

confidence: 99%

“…It is already established as an accurate test to differentiate tracheal from esophageal intubation. [1][2][3][4][5][6][7][8] An ETT cuff that is located at the level of the suprasternal notch correlates to correct depth of ETT insertion. [29][30][31][32] A cuff filled with air, however, cannot be reliably distinguished from the surrounding air-filled trachea.…”

Section: Cjem N Jcmumentioning

confidence: 99%

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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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Use of Bedside Ultrasonography for Endotracheal Tube Placement in Pediatric Patients: A Feasibility Study

Abstract: Bedside ultrasonography can be used to accurately and rapidly determine the presence of the endotracheal tube within the trachea in pediatric patients.

Cited by 125 publications

References 19 publications

Ultrasound Confirmation of Endotracheal Tube Position in Neonates

Ultrasound Confirmation of Endotracheal Tube Position in Neonates

Utilizing Nasal-Tragus Length to Estimate Optimal Endotracheal Tube Depth for Neonates in Taiwan

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

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