Majidinejad Saeed, Heydari Farhad, Asadolahian Mohamadreza
Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2023 Jan 27;12:15. doi: 10.4103/abr.abr_37_21. eCollection 2023.
Endotracheal intubation is the basic method of providing a safe cross-sectional airway area and the incorrect placement can be dangerous and causes complications. So this study aimed to access the diagnostic value of color Doppler epigastric ultrasound and linear probe suprasternal notch ultrasound in comparison with standard capnography in confirmation of endotracheal tube (ETT) placement after intubation.
This diagnostic value study was conducted on 104 patients requiring intubation who were referred to the Emergency Department. After the intubation, color Doppler epigastric ultrasound and suprasternal notch ultrasound as well as the standard capnography were used to confirm the placement ETT.
The sensitivity and specificity of color Doppler epigastric ultrasound were 97.96% and 100%, for suprasternal notch ultrasound were 98.98% and 66.67%, and for combination of the both methods were 96.94% and 100% respectively that showed the significant diagnostic value in the confirmation of ETT placement ( < 0.001). The mean of elapsed time to confirm the ETT placement by the standard capnography method (17.95 ± 2.45 s) was significantly more than the two methods of epigastric ultrasound (10.38 ± 4.65 s) and suprasternal notch ultrasound (5.08 ± 4.45 s) as well as the combined method with the mean of 15.46 ± 8.31 s ( < 0.001).
The results of this study showed that although ultrasound is a potentially accurate, fast, and reliable method to confirm the endotracheal tube placement, but suprasternal notch ultrasound is considered to be a more appropriate diagnostic technique due to its higher sensitivity and less detection time compared to epigastric ultrasound and combined method.
气管插管是提供安全气道横截面积的基本方法，插管位置错误可能很危险并会引发并发症。因此，本研究旨在评估彩色多普勒上腹部超声和线性探头胸骨上切迹超声与标准二氧化碳波形图相比，在确认插管后气管导管（ETT）位置方面的诊断价值。
本诊断价值研究对104例需要插管的患者进行，这些患者被转诊至急诊科。插管后，使用彩色多普勒上腹部超声、胸骨上切迹超声以及标准二氧化碳波形图来确认ETT的位置。
彩色多普勒上腹部超声的敏感性和特异性分别为97.96%和100%，胸骨上切迹超声分别为98.98%和66.67%，两种方法联合使用时分别为96.94%和100%，这表明在确认ETT位置方面具有显著的诊断价值（<0.001）。通过标准二氧化碳波形图方法确认ETT位置的平均耗时（17.95±2.45秒）显著长于上腹部超声（10.38±4.65秒）、胸骨上切迹超声（5.08±4.45秒）以及联合方法（平均为15.46±8.31秒）（<0.001）。
本研究结果表明，尽管超声是确认气管导管位置的一种潜在准确、快速且可靠的方法，但与上腹部超声及联合方法相比，胸骨上切迹超声因其更高的敏感性和更短的检测时间，被认为是一种更合适的诊断技术。
