Utilidad de la ecografía comparada con la capnografía y la radiografía en la intubación traqueal

Quintela, Paula Alonso; Oulego-Erróz, Ignacio; Matilla, M. Mora; Blanco, S. Rodríguez; Zubillaga, D. Mata; Santos, Laura Regueras

doi:10.1016/j.anpedi.2014.01.004

Cited by 32 publications

(6 citation statements)

References 22 publications

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“…In line with the reported figures for diagnostic validity of UA-US for confirmation of ETT position, Alonso Quintela et al [9] reported that US appears to be as effective as capnography for identifying ETT and may be useful wherever capnography is less reliable as during cardiopulmonary resuscitation. Thereafter, Das et al [17] reported that transtracheal US is a useful tool to confirm endotracheal intubation with sensitivity and specificity rates of 98% in both emergency and elective intubation.…”

Section: Discussionsupporting

confidence: 66%

“…In line with these findings, Pfeiffer et al [24,25] documented that verification of ETT placement with US is as fast as auscultation alone and faster than the combination of auscultation and capnography, even in obese patients [23]. Thereafter, Alonso Quintela et al [9] reported despite US was slower than capnography for identifying ETT, US is as effective and quicker than X-ray for assessment of ETT insertion depth, and it may contribute to decrease the routine use of X-ray after tracheal intubation. Recently, Rajan et al [23] documented that US confirmation of ETT placement is superior in speed compared to auscultatory method.…”

Section: Discussionsupporting

confidence: 53%

“…However, anesthesia providers often delay timely charting of ET intubation and this latency may result in decreased efficacy of clinical decision support systems [8]. Bedside ultrasonography had been widely used for preliminary diagnoses especially in bedridden patients [9] and in emergency medicine [10] and to aid for diagnostic decision making in emergency department [11].…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of Bedside Upper Airway Ultrasonography vs. Standard Auscultation for Assuring the Location of Endotracheal Tube after Tracheal Intubation: Comparative Study Controlled by Quantitative Waveform Capnography

Arafa¹,

Abouzkry²,

Mohamady³

2017

J Anesth Clin Res

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Objectives: To estimate the accuracy and rapidity of bed-side upper airway ultrasonography (UA-US) versus standard auscultation (SA) for confirmation of endotracheal tube (ETT) position. Patients and methods:107 patients underwent tracheal intubation for maintenance of general anesthesia. Position of ETT was confirmed by chest auscultation for the presence of breath sounds on both sides, and by UA-US using 9-12 MHz linear US transducer that was placed transversely on the neck anteriorly and superior to the suprasternal notch to visualize the ETT in the tracheal transverse and longitudinal views. The data obtained were compared to findings on using waveform capnography (WC). Time to define ETT position was determined. Study outcomes included determination of ETT position; tracheal or esophageal, accuracy of diagnosis and time taken till confirming the diagnosis. Results:With comparison to WC findings, UA-US revealed sensitivity, specificity and accuracy rates of 97%, 71.4% and 95.3% while that for SA were 93.6%, 53.9% and 88.8%, respectively with significantly higher specificity and accuracy rates for UA-WC versus SA. Time required for confirmation of ETT position was significantly shorter with WC (9.16 ± 0.69 sec.) compared to SA and UA-US with significant difference in favor of UA-US (11.14 ± 1.3 vs. 13.5 ± 2.15 sec). Conclusion:Confirmation of ETT position using UA-US or WC is very important because of the high false result depending on SA alone. UA-US using bed-side equipment is a simple, accurate and fast method than SA compared to WC as a gold standard, so it is recommended to be one of the important theater equipments whenever possible

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Section: Discussionsupporting

confidence: 66%

Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

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Accuracy of Bedside Upper Airway Ultrasonography vs. Standard Auscultation for Assuring the Location of Endotracheal Tube after Tracheal Intubation: Comparative Study Controlled by Quantitative Waveform Capnography

Arafa¹,

Abouzkry²,

Mohamady³

2017

J Anesth Clin Res

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“…[20] Lung sonography is considered more sensitive than traditional upright chest radiography in detecting pneumothorax and it allows a rapid bedside evaluation of an unstable patient. [21]…”

Section: Discussionmentioning

confidence: 99%

Rapidity and efficacy of ultrasonographic sliding lung sign and auscultation in confirming endotracheal intubation in overweight and obese patients

et al. 2017

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“…To our knowledge, only two previous studies have utilized ultrasound in real time for the confirmation of ETT position with comparison to standard-of-care methods [28, 29]. The first study included 16 NICU intubations and found a sensitivity of 92% and a specificity of 100% for ultrasound compared to capnography.…”

Section: Discussionmentioning

confidence: 99%

A novel training simulator for portable ultrasound identification of incorrect newborn endotracheal tube placement – observational diagnostic accuracy study protocol

et al. 2019

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BackgroundEndotracheal tube (ETT) placement is a critical procedure for newborns that are unable to breathe. Inadvertent esophageal intubation can lead to oxygen deprivation and consequent permanent neurological impairment. Current standard-of-care methods to confirm ETT placement in neonates (auscultation, colorimetric capnography, and chest x-ray) are time consuming or unreliable, especially in the stressful resuscitation environment. Point-of-care ultrasound (POCUS) of the neck has recently emerged as a powerful tool for detecting esophageal ETTs. It is accurate and fast, and is also easy to learn and perform, especially on children.MethodsThis will be an observational diagnostic accuracy study consisting of two phases and conducted at the Aga Khan University Hospital in Karachi, Pakistan. In phase 1, neonatal health care providers that currently perform standard-of-care methods for ETT localization, regardless of experience in portable ultrasound, will undergo a two-hour training session. During this session, providers will learn to detect tracheal vs. esophageal ETTs using POCUS. The session will consist of a didactic component, hands-on training with a novel intubation ultrasound simulator, and practice with stable, ventilated newborns. At the end of the session, the providers will undergo an objective structured assessment of technical skills, as well as an evaluation of their ability to differentiate between tracheal and esophageal endotracheal tubes. In phase 2, newborns requiring intubation will be assessed for ETT location via POCUS, at the same time as standard-of-care methods. The initial 2 months of phase 2 will include a quality assurance component to ensure the POCUS accuracy of trained providers. The primary outcome of the study is to determine the accuracy of neck POCUS for ETT location when performed by neonatal providers with focused POCUS training, and the secondary outcome is to determine whether neck POCUS is faster than standard-of-care methods.DiscussionThis study represents the first large investigation of the benefits of POCUS for ETT confirmation in the sickest newborns undergoing intubations for respiratory support.Trial registrationClinicalTrials.gov Identifier: NCT03533218. Registered May 2018.

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Utilidad de la ecografía comparada con la capnografía y la radiografía en la intubación traqueal

Cited by 32 publications

References 22 publications

Accuracy of Bedside Upper Airway Ultrasonography vs. Standard Auscultation for Assuring the Location of Endotracheal Tube after Tracheal Intubation: Comparative Study Controlled by Quantitative Waveform Capnography

Accuracy of Bedside Upper Airway Ultrasonography vs. Standard Auscultation for Assuring the Location of Endotracheal Tube after Tracheal Intubation: Comparative Study Controlled by Quantitative Waveform Capnography

Rapidity and efficacy of ultrasonographic sliding lung sign and auscultation in confirming endotracheal intubation in overweight and obese patients

A novel training simulator for portable ultrasound identification of incorrect newborn endotracheal tube placement – observational diagnostic accuracy study protocol

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