Li Xuxia, Zhang Jiapeng, Karunakaran Monica, Hariharan Vishnu Shankar
Department of Ultrasonography, Dingxi People's Hospital of Gansu Province, Dingxi City, Gansu Province, 743000, China.
Department of Emergency Treatment, Sisui People's Hospital, Jining, Shangdong Province, 272000, China.
Med Ultrason. 2023 Mar 30;25(1):72-81. doi: 10.11152/mu-3594. Epub 2022 Jun 3.
Despite several studies and reviews reporting data accuracy of ultrasonography for confirmation of endotracheal intubation, there has been limited pooled evidence summarizing the diagnostic accuracy of this imaging modality, especially based on recent evidence. Hence, the current study reviews the recent literature and conducts a meta-analysis to compare the accuracy of ultrasonography for the confirmation of endotracheal tube placement.
We conducted a systematic search for all studies reporting the diagnostic accuracy of ultrasonography in the databases of Medline, EMBASE,PubMed Central, ScienceDirect, Google Scholar & Cochrane library from inception till December 2021. Meta-analysis was performed using STATA software "midas" package.
Thirty-eight studies with 3,268 participants were included. Thepooled sensitivity was 98% (95% CI, 97%-99%) and specificity was 95% (95% CI, 90%-98%), respectively. The AUC was 0.98 (95%CI: 0.96-1.00). The pooled DOR was 1090 (95% CI, 408-2910). Pooled LRP was 19 (95% CI, 9-39) and pooled LRN was 0.02 (0.01-0.03). There was significant heterogeneity found in the outcome with significant chi-square tests and I2 statistics > 75%.
Findings from our review demonstrate promise in the applicability of ultrasonography as a major diagnostic tool for confirming the endotracheal tube intubation.
尽管有多项研究和综述报告了超声检查用于确认气管插管的数据准确性，但汇总性证据有限，无法总结这种成像方式的诊断准确性，尤其是基于近期证据。因此，本研究回顾了近期文献并进行荟萃分析，以比较超声检查确认气管导管位置的准确性。
我们对Medline、EMBASE、PubMed Central、ScienceDirect、谷歌学术和考克兰图书馆数据库中自创建至2021年12月期间所有报告超声检查诊断准确性的数据进行了系统检索。使用STATA软件的“midas”包进行荟萃分析。
纳入了38项研究，共3268名参与者。汇总敏感度为98%（95%置信区间，97%-99%），特异度为95%（95%置信区间，90%-98%）。曲线下面积为0.98（95%置信区间：0.96-1.00）。汇总诊断比值比为1090（95%置信区间，408-2910）。汇总阳性似然比为19（95%置信区间，9-39），汇总阴性似然比为0.02（0.01-0.03）。通过显著的卡方检验和I²统计量>75%，发现结果存在显著异质性。
我们的综述结果表明，超声检查作为确认气管插管的主要诊断工具具有应用前景。
