Park Soon Chang, Ryu Ji Ho, Yeom Seok Ran, Jeong Jin Woo, Cho Suck Ju
Department of Emergency Medicine, Pusan National University Hospital, Busan, South Korea.
Emerg Med Australas. 2009 Aug;21(4):293-7. doi: 10.1111/j.1742-6723.2009.01199.x.
The objective of the present study was to investigate whether the combined use of transcricothyroid membrane ultrasonography and ultrasonographic evaluation for pleural sliding is useful for verifying endotracheal intubation in the ED.
We performed a prospective clinical trial in the ED from January to July 2008. All patients enrolled in the present study had been admitted to the ED owing to severe airway problems. A linear probe was placed horizontally over the cricothyroid membrane (dynamic phase) during the intubation process. Endotracheal intubation was confirmed by ultrasonographic lung sliding. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.
Thirty patients (17 men, 13 women; mean age 59.6 +/- 16.7 [SD] years) were enrolled in the study. Of the 30, 7 had a history of trauma. Four trauma patients were diagnosed with haemopneumothorax. The ratio of initial oesophageal-to-endotracheal intubation was 3:27. Sensitivity, specificity, PPV and NPV for endotracheal intubation were 96.3%, 100%, 100% and 75%, respectively. After verification by ultrasonographic lung sliding, sensitivity, specificity, PPV and NPV were each 100%.
The combination of transcricothyroid membrane ultrasonography and ultrasonographic lung-sliding evaluation could be useful in confirming endotracheal intubation in the ED.
本研究的目的是探讨联合使用环甲膜超声检查和胸膜滑动超声评估在急诊科（ED）验证气管插管方面是否有用。
我们于2008年1月至7月在急诊科进行了一项前瞻性临床试验。本研究纳入的所有患者均因严重气道问题入住急诊科。在插管过程中，将线性探头水平放置在环甲膜上（动态阶段）。通过超声肺滑动确认气管插管。计算敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
30例患者（17例男性，13例女性；平均年龄59.6±16.7[标准差]岁）纳入研究。30例患者中，7例有外伤史。4例外伤患者被诊断为血气胸。初次食管插管与气管插管的比例为3:27。气管插管的敏感性、特异性、PPV和NPV分别为96.3%、100%、100%和75%。经超声肺滑动验证后，敏感性、特异性、PPV和NPV均为100%。
环甲膜超声检查与超声肺滑动评估相结合可能有助于在急诊科确认气管插管。
