Li Yansong, Xie Ying, Hu Bailong, Wang Jing, Song Haibo, Wei Xinchuan
From the Department of Anaesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041 (YL, YX, JW, BH, HS, XW); Department of Anaesthesiology, Northwest Women's and Children's Hospital, Xi'an, Shaanxi Province, 710000 (JW); Department of Anaesthesiology, Nanchong Central Hospital, Nanchong, Sichuan Province, 637000 (YX); and Department of Anaesthesiology, Affiliated hospital of Guiyang Medical College into Guizhou Medical University, Guiyang, Guizhou Province, 550001 (BH).
Medicine (Baltimore). 2015 Aug;94(34):e1460. doi: 10.1097/MD.0000000000001460.
This study aimed to explore the sensitivity and specificity an approach to confirm the depth of the endotracheal tube. It was a prospective, diagnostic study (Registration number: chiCTR-TRC-14005170) conducted in the Department of Anesthesiology of West China Hospital. A total of 100 patients underwent general anesthesia were included. The distance between the upper margin of the cuff and the manubriosternal joint (CM) and the distance between the upper margin of the cuff and the carina (CC) were measured. The accuracy of the confirmed approach against fiberoptic bronchoscopy (FOB) was evaluated. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. The correlation and agreement between CM and CC were explored.The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined to be 94.74% (95% CI: 87.07-98.55%), 79.17% (95% CI: 57.85-92.87%), 93.51% (95% CI: 85.49-97.86%), 82.61% (95% CI: 61.22%-95.05%), respectively. The κ value was 0.75 (95% CI: 0.60-0.90). There was a significant correlation between CM and CC (P < 0.001) with a correlation coefficient of 0.91(95% CI: 0.87-0.94). Bland and Altman plots also demonstrated a good agreement between the CM and CC. This novel method may be used to confirm the depth of the endotracheal tubes.
本研究旨在探讨一种确认气管导管深度方法的敏感性和特异性。这是一项在中国华西医院麻醉科进行的前瞻性诊断研究（注册号：chiCTR - TRC - 14005170）。共纳入100例行全身麻醉的患者。测量了气管导管套囊上缘与胸骨柄关节（CM）之间的距离以及气管导管套囊上缘与隆突（CC）之间的距离。评估了该确认方法相对于纤维支气管镜检查（FOB）的准确性。计算了敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。探讨了CM与CC之间的相关性和一致性。结果确定敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为94.74%（95%CI：87.07 - 98.55%）、79.17%（95%CI：57.85 - 92.87%）、93.51%（95%CI：85.49 - 97.86%）、82.61%（95%CI：61.22% - 95.05%）。κ值为0.75（95%CI：0.60 - 0.90）。CM与CC之间存在显著相关性（P＜0.001），相关系数为0.91（95%CI：0.87 - 0.94）。Bland - Altman图也显示CM与CC之间具有良好的一致性。这种新方法可用于确认气管导管的深度。
