Milling Truman John, Jones Matthew, Khan Tara, Tad-y Darlene, Melniker Lawrence A, Bove Joseph, Yarmush Jody, SchianodiCola Joseph
Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, New York 11215-9008, USA.
J Emerg Med. 2007 May;32(4):409-14. doi: 10.1016/j.jemermed.2006.08.022. Epub 2007 Apr 16.
This prospective, blinded, observational, efficacy study is one of the first to evaluate ultrasound in detecting esophageal intubation, a significant source of morbidity and mortality. We utilized a convenience sample of patients undergoing elective surgery during July 2004 in an urban teaching hospital. Trained Emergency Physician sonographers performed transtracheal ultrasounds of intubations to identify esophageal intubation. In 35 of the 40 patients enrolled, there was intubation of the trachea, whereas esophageal intubation occurred in five patients. Sonographers correctly identified all five esophageal intubations, for a sensitivity of 100% (95% confidence interval [CI] 48-100). Ultrasound correctly identified 34 of 35 tracheal intubations and misidentified one resulting in a specificity of 97% (95% CI 90-100). It seems that transtracheal ultrasound may be an efficacious adjunct for detecting esophageal intubation.
这项前瞻性、盲法、观察性疗效研究是首批评估超声检测食管插管（发病率和死亡率的重要来源）的研究之一。我们采用了2004年7月在一家城市教学医院接受择期手术患者的便利样本。经过培训的急诊医生超声检查人员对插管进行经气管超声检查以识别食管插管。在纳入的40例患者中，35例气管插管，5例食管插管。超声检查人员正确识别了所有5例食管插管，敏感性为100%（95%置信区间[CI]48 - 100）。超声正确识别了35例气管插管中的34例，误诊1例，特异性为97%（95%CI 90 - 100）。经气管超声似乎可能是检测食管插管的有效辅助手段。
