Department of Ultrasonography, The second Affiliated Hospital and Yuying children's Hospital of Wenzhou Medical University, Wenzhou, 325006, Zhejiang, China.
Department of Ultrasonography, Lucheng People's Hospital of Wenzhou, Wenzhou, 325006, Zhejiang, China.
BMC Anesthesiol. 2021 Jun 24;21(1):177. doi: 10.1186/s12871-021-01398-3.
Recent studies indicate that ultrasound can detect changes in tracheal diameter during endotracheal tube (ETT) cuff inflation. We sought to assess the accuracy of ultrasound measurement of tracheal diameter, and to determine the relationship between tracheal wall pressure (TWP), cuff inflation volume (CIV), and the degree of tracheal deformation.
Our study comprised two parts: the first included 45 porcine tracheas, the second 41 porcine tracheas. Each trachea was intubated with a cuffed ETT, which was connected to an injector and the manometer via a three-way tap. The cuff was inflated and the cuff pressure recorded before and after intubation. The tracheal diameter was measured using ultrasound. This included three separate measurements: outer transverse diameter (OTD), internal transverse diameter (ITD), and anterior tracheal wall thicknesses (ATWT). A precision electronic Vernier caliper was also used to measure tracheal diameter. We calculated TWP and the percentage change of tracheal diameter. The Bland-Altman method, linear regression, and locally weighted regression (LOESS) were used to analyze the data.
There were strong correlation and agreement for OTD (r = 0.97, P < 0.001) and ITD (r = 0.90, P < 0.001) as measured by ultrasound and by precision electronic Vernier caliper, but a poor correlation for ATWT (r = 0.58, P < 0.001). There was a strong correlation between the percentage change of OTD (OTD%, r = 0.75, P < 0.001) and CIV, the percentage change of ITD (ITD%, r = 0.77, P < 0.001) and CIV, TWP (r = 0.75, P < 0.001) and CIV. And a strong correlation was also found between TWP and OTD% (r = 0.84, P < 0.001), TWP and ITD% (r = 0.84, P < 0.001).
Use of ultrasound to measure OTD and ITD is accurate, but is less accurate for ATWT. There is a close correlation between OTD%, ITD%, CIV and TWP.
最近的研究表明，超声可以检测气管导管（ETT）套囊充气时气管直径的变化。我们试图评估超声测量气管直径的准确性，并确定气管壁压力（TWP）、套囊充气量（CIV）和气管变形程度之间的关系。
我们的研究包括两部分：第一部分包括 45 个猪气管，第二部分包括 41 个猪气管。每个气管都用带套囊的 ETT 插管，通过三通阀与注射器和压力计相连。插管前和插管后记录套囊压力，使用超声测量气管直径。这包括三个独立的测量值：外横径（OTD）、内横径（ITD）和前气管壁厚度（ATWT）。还使用精密电子游标卡尺测量气管直径。我们计算了 TWP 和气管直径的百分比变化。使用 Bland-Altman 法、线性回归和局部加权回归（LOESS）分析数据。
超声测量的 OTD（r=0.97，P<0.001）和 ITD（r=0.90，P<0.001）与精密电子游标卡尺测量的 OTD 和 ITD 有很强的相关性和一致性，但 ATWT 的相关性较差（r=0.58，P<0.001）。OTD%（OTD%，r=0.75，P<0.001）与 CIV、ITD%（ITD%，r=0.77，P<0.001）与 CIV、TWP（r=0.75，P<0.001）与 CIV 之间有很强的相关性。TWP 与 OTD%（r=0.84，P<0.001）、TWP 与 ITD%（r=0.84，P<0.001）之间也存在很强的相关性。
超声测量 OTD 和 ITD 准确，但 ATWT 准确性较差。OTD%、ITD%、CIV 和 TWP 之间存在密切相关性。
