Department of Emergency Medicine, School of Medicine, Akdeniz University, 07059 Antalya, Turkey.
Am J Emerg Med. 2010 Jan;28(1):32-6. doi: 10.1016/j.ajem.2008.09.024.
None of the techniques used for confirmation of endotracheal tube (ET) placement are proven reliable 100% of the time. The purpose of our study is to determine whether ultrasound can accurately detect the passage of ET through the trachea and esophagus and to see whether this visualization is augmented with the use of a metal stylet.
A total of 7 physicians made assessments of ET positions using an ultrasound during their passage through the trachea or esophagus. A total of 40 esophageal and 40 tracheal intubations were performed randomly in a blinded fashion on a fresh, unfrozen human cadaver. Half were performed with a metal stylet and the other half without a stylet.
During transtracheal assessment regardless of stylet use, correct identification of ET position was achieved in 275 of 280 esophageal intubations and 268 of 280 tracheal intubations. The overall sensitivity was 95.7%, and specificity was 98.2%. The presence and the absence of stylet was identified in 109 of 280 and in 155 of 280 attempts, respectively. Correct identification of stylet presence yielded a sensitivity of 38.9% and a specificity of 55.4%. Ultrasound can be used by emergency physicians to accurately detect the passage of ET through the trachea and esophagus; however, stylet use did not augment ET visualization.
目前尚无任何一种用于确认气管内导管（ET）位置的技术能 100%可靠。本研究旨在确定超声是否能准确检测 ET 通过气管和食管的过程，以及使用金属导丝是否能增强这种可视化效果。
共有 7 名医生在超声引导下对通过气管或食管的 ET 位置进行评估。在一具新鲜、未冷冻的人体尸体上，以盲法随机进行了 40 次食管插管和 40 次气管插管。其中一半使用金属导丝，另一半不使用导丝。
无论是否使用导丝进行经气管评估，在 280 次食管插管中，有 275 次正确识别了 ET 位置，在 280 次气管插管中，有 268 次正确识别了 ET 位置。总体敏感性为 95.7%，特异性为 98.2%。在 280 次尝试中，分别有 109 次和 155 次识别出导丝的存在和不存在。正确识别导丝存在的敏感性为 38.9%，特异性为 55.4%。急诊医生可以使用超声准确检测 ET 通过气管和食管的过程；然而，导丝的使用并没有增强 ET 的可视化效果。
