Department of Respiratory and Critical Care Medicine, Second Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Ultrasound Medicine, Third Hospital of Hebei Medical University, Shijiazhuang, China.
J Ultrasound Med. 2020 Mar;39(3):509-513. doi: 10.1002/jum.15127. Epub 2019 Sep 6.
Obesity is a serious disorder that may lead to numerous difficulties in endotracheal tube (ETT) management. This study investigated the potential of tracheal ultrasound (TUS) for the accurate confirmation of the ETT position in obese patients.
A total of 68 obese patients undergoing tracheal intubation were enrolled in this study from January 2017 to June 2018. All patients received auscultation and TUS to evaluate the ETT position, which was ultimately verified by bronchoscopy. A correct position of the ETT was defined as placement at the trachea, whereas placement at the right/left main bronchus was classified as an incorrect position.
We found 58 correct placements of the ETT at the trachea, 8 incorrect placements at the right main bronchus, and 2 incorrect placements at the left main bronchus. Compared with auscultation, TUS showed higher accuracy (85.29% versus 67.65%; P = .005), sensitivity (84.48% versus 67.24%; P = .005), and specificity (90.00% versus 70.00%; P < .001), as well as lower rates of false-positive (10.00% versus 30.00%; P < .001) and false-negative (15.52% versus 32.76%; P = .005) results for detecting the correct placement of the ETT, defined as placement at the trachea.
Tracheal ultrasound is highly sensitive and specific in confirming the ETT position in obese patients.
肥胖是一种严重的疾病，可能导致气管内导管（ETT）管理出现诸多困难。本研究旨在探讨气管超声（TUS）在肥胖患者中准确确认 ETT 位置的潜力。
本研究纳入了 2017 年 1 月至 2018 年 6 月期间进行气管插管的 68 例肥胖患者。所有患者均接受听诊和 TUS 评估 ETT 位置，最终通过支气管镜确认。将 ETT 正确位置定义为气管内，而将 ETT 置于右/左主支气管内定义为不正确位置。
我们发现 58 例 ETT 正确置于气管内，8 例 ETT 不正确置于右主支气管内，2 例 ETT 不正确置于左主支气管内。与听诊相比，TUS 的准确性（85.29%比 67.65%；P=0.005）、敏感性（84.48%比 67.24%；P=0.005）和特异性（90.00%比 70.00%；P < 0.001）更高，假阳性率（10.00%比 30.00%；P < 0.001）和假阴性率（15.52%比 32.76%；P=0.005）更低，用于检测 ETT 正确位置（即气管内）。
TUS 可高度敏感且特异确认肥胖患者的 ETT 位置。
