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Comparative study of the reliability of ultrasound to confirm the position of endotracheal tube with cuff inflated with saline versus air. | LitMetric

Comparative study of the reliability of ultrasound to confirm the position of endotracheal tube with cuff inflated with saline versus air.

J Ultrason

Service d'Anesthésiologie-réanimation et médecine péri-operatoire, Chru de Nancy, Nancy, France.

Published: November 2021

AI Article Synopsis

  • A study aimed to evaluate the effectiveness of transtracheal ultrasound in confirming the position of an endotracheal tube, comparing cuffs inflated with saline and air.
  • The experiment involved four techniques (air/saline with the tube in the trachea or esophagus) and measured success rates among residents using ultrasound to determine tube placement.
  • Results showed a success rate improvement from 46.5% in the first series to 72.9% in the second, but overall performance was poor with the ultrasound method, regardless of cuff type.

Article Abstract

To compare the reliability of transtracheal ultrasound to confirm the endotracheal tube position with saline versus air inflated cuff. This was a prospective randomized cadaveric study. Four techniques were randomized: endotracheal tube in the trachea with air or saline inflated cuff, and endotracheal tube in the esophagus with air or saline inflated cuff. The investigator used the Mcgrath to randomly place the endotracheal tube in the trachea or in the esophagus with saline or air inflated cuff. During the first series of measurements, nine residents performed transtracheal ultrasound with linear transducer placed transversely at the suprasternal notch. They were recorded with a cut off fixed to 30 seconds, and a questionnaire was completed by the residents after each transtracheal ultrasound in order to report where the endotracheal tube is positioned according to them. The second series followed the same protocol and included three residents who had participated in the first series. The primary outcome was the success rate in determining the position of the endotracheal tube. In the first series, the success rate was 46.5%. In the second series, the success rate was 72.9%. There was no significant difference between cuff inflated with saline and air ( = 1.00). The overall mean time required was 20.6 s (95% CI 13.0-28.2 s). Based on an empirical data set, transtracheal ultrasound had a sensitivity of 62.2%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 26.08%. This investigation shows that regardless of the contents of the endotracheal tube cuff, the use of transtracheal ultrasound to confirm the position of endotracheal tube reports disappointing results.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8678644PMC
http://dx.doi.org/10.15557/JoU.2021.0050DOI Listing

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