Sethi Ashok K, Salhotra Rashmi, Chandra Monika, Mohta Medha, Bhatt Shuchi, Kayina Choro A
Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
Department of Anaesthesiology, Maulana Azad Medical College and LN Hospital, Delhi, India.
J Anaesthesiol Clin Pharmacol. 2019 Jul-Sep;35(3):353-358. doi: 10.4103/joacp.JOACP_317_18.
Confirmation of endotracheal tube (ETT) position is necessary to ensure proper ventilation. The present study was conducted with the aim to compare the efficacy of three ultrasonographic (USG) techniques in terms of time taken for confirmation of ETT position. The time taken by each USG technique was also compared with that for auscultation and capnography. The ability of the three USG techniques to identify tracheal placement of ETT was evaluated in all patients.
Ninety adult American Society of Anesthesiologists (ASA) I/II patients requiring general anaesthesia with tracheal intubation were randomised into three groups ( = 30 each) depending upon the initial USG transducer position used to confirm tracheal placement of ETT: group T (tracheal), group P (pleural) and group D (diaphragm). The time taken for confirmation of tracheal placement of ETT by USG, auscultation and capnography was recorded for each of the groups. Subsequently, USG confirmation of ETT placement was performed with the other two USG techniques in all patients.
The time taken for USG in group T was significantly less (3.8 ± 0.9 s) compared to group P (12.1 ± 1.6 s) and group D (13.8 ± 1.7 s); < 0.001. USG was significantly faster than both auscultation and capnography in group T ( < 0.001), whereas in group P and group D, USG took longer time compared to auscultation ( = 0.014 and < 0.001, respectively) but lesser time than capnography ( < 0.001 in both groups).
USG is a rapid technique for identification of ETT placement. All the three USG techniques are reliable in identifying the tracheal placement of ETT.
确认气管插管（ETT）位置对于确保恰当通气很有必要。本研究旨在比较三种超声（USG）技术在确认ETT位置所需时间方面的效果。还将每种USG技术所用时间与听诊和二氧化碳描记法所用时间进行了比较。评估了所有患者中三种USG技术识别ETT气管内放置的能力。
90例需要全身麻醉并进行气管插管的美国麻醉医师协会（ASA）I/II级成年患者，根据用于确认ETT气管内放置的初始USG换能器位置随机分为三组（每组n = 30）：T组（气管）、P组（胸膜）和D组（膈肌）。记录每组通过USG、听诊和二氧化碳描记法确认ETT气管内放置所需的时间。随后，所有患者用另外两种USG技术进行ETT放置的USG确认。
与P组（12.1±1.6秒）和D组（13.8±1.7秒）相比，T组USG所用时间显著更短（3.8±0.9秒）；P < 0.001。在T组，USG明显比听诊和二氧化碳描记法更快（P < 0.001），而在P组和D组，USG与听诊相比用时更长（分别为P = 0.014和P < 0.001），但比二氧化碳描记法用时少（两组均为P < 0.001）。
USG是一种快速识别ETT放置位置的技术。所有三种USG技术在识别ETT气管内放置方面都是可靠的。
