Tracheal Ultrasound for the Accurate Confirmation of the Endotracheal Tube Position in Obese Patients.

J Ultrasound Med

Department of Respiratory and Critical Care Medicine, Second Hospital of Hebei Medical University, Shijiazhuang, China.

Published: March 2020

AI Article Synopsis

  • The study investigated the effectiveness of tracheal ultrasound (TUS) compared to traditional auscultation for confirming endotracheal tube (ETT) placement in obese patients.
  • A total of 68 obese patients were evaluated, with outcomes verified by bronchoscopy; TUS demonstrated significantly higher accuracy and lower false-positive and false-negative rates than auscultation.
  • The results suggest that TUS is a more reliable method for ensuring correct ETT positioning in obese individuals.

Article Abstract

Objectives: Obesity is a serious disorder that may lead to numerous difficulties in endotracheal tube (ETT) management. This study investigated the potential of tracheal ultrasound (TUS) for the accurate confirmation of the ETT position in obese patients.

Methods: A total of 68 obese patients undergoing tracheal intubation were enrolled in this study from January 2017 to June 2018. All patients received auscultation and TUS to evaluate the ETT position, which was ultimately verified by bronchoscopy. A correct position of the ETT was defined as placement at the trachea, whereas placement at the right/left main bronchus was classified as an incorrect position.

Results: We found 58 correct placements of the ETT at the trachea, 8 incorrect placements at the right main bronchus, and 2 incorrect placements at the left main bronchus. Compared with auscultation, TUS showed higher accuracy (85.29% versus 67.65%; P = .005), sensitivity (84.48% versus 67.24%; P = .005), and specificity (90.00% versus 70.00%; P < .001), as well as lower rates of false-positive (10.00% versus 30.00%; P < .001) and false-negative (15.52% versus 32.76%; P = .005) results for detecting the correct placement of the ETT, defined as placement at the trachea.

Conclusions: Tracheal ultrasound is highly sensitive and specific in confirming the ETT position in obese patients.

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Source
http://dx.doi.org/10.1002/jum.15127DOI Listing

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