Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea.
Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
Am J Emerg Med. 2020 Dec;38(12):2629-2633. doi: 10.1016/j.ajem.2020.07.080. Epub 2020 Aug 9.
This study aimed to investigate the efficacy of transtracheal ultrasonography in confirming the placement of an endotracheal tube introducer during endotracheal intubation using the I-gel supraglottic airway as a guide.
In this prospective study, endotracheal intubation using an endotracheal tube introducer through the I-gel was performed in patients with return of spontaneous circulation after I-gel insertion for out-of-hospital cardiac arrest. The introducer placement was assessed by the occurrence of hyperechoic artifacts within the trachea or esophagus in transtracheal ultrasonography. Results of ultrasonography were confirmed by waveform capnography in the case of tracheal artifacts and direct visualization by laryngoscopy in the case of esophageal artifacts.
One hundred and six patients were enrolled in this study. In transtracheal ultrasonography, artifacts of introducer in the trachea and esophagus were observed in 80 (75.5%) and 26 (24.5%) patients, respectively. Transtracheal ultrasonography in identifying the placement of introducers revealed a sensitivity of 100% (95% CI 95.4 to 100), specificity of 96.3% (95% CI 81.0 to 99.9), a PPV of 98.7% (95% CI 92.0 to 99.8), and a NPV of 100% (95% CI 94.8 to 99.9).
Transtracheal ultrasonography is an accurate method for identifying introducer placement during endotracheal intubation using an endotracheal tube introducer through the I-gel.
本研究旨在探讨经 I-gel 引导行气管内插管时，利用经气管超声确认气管内导管导入器位置的效果。
本前瞻性研究纳入了在 I-gel 置入后心跳骤停患者中，使用气管内导管导入器经 I-gel 行气管内插管的患者。通过经气管超声观察到气管或食管内出现强回声伪影来评估导入器的位置。如果出现气管伪影，则通过波形二氧化碳描记法确认超声结果，如果出现食管伪影，则通过直接喉镜进行确认。
本研究共纳入了 106 例患者。在经气管超声中，分别有 80 例（75.5%）和 26 例（24.5%）患者观察到导入器在气管和食管中的伪影。经气管超声识别导入器位置的敏感性为 100%（95%可信区间 95.4 至 100），特异性为 96.3%（95%可信区间 81.0 至 99.9），阳性预测值为 98.7%（95%可信区间 92.0 至 99.8），阴性预测值为 100%（95%可信区间 94.8 至 99.9）。
经气管超声是一种在经 I-gel 引导行气管内插管时，利用气管内导管导入器识别导入器位置的准确方法。
