Sreedevi Jayalekshmi, Neethu George, Anjali George, Cherish Paul
Travancore Medical College, Kollam, Kerala, India.
Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.
J Crit Care Med (Targu Mures). 2024 Apr 30;10(2):177-182. doi: 10.2478/jccm-2024-0019. eCollection 2024 Apr.
Airway ultrasound has been increasingly used in correct positioning of endotracheal tube. We hypothesize that a safe distance between endotracheal tube tip and carina can be achieved with the aid of ultrasound.
Our primary objective was to determine whether ultrasound guided visualisation of proximal end of endotracheal tube cuff is better when compared to conventional method in optimal positioning of tube tip. The secondary objective was to find the optimal endotracheal tube position at the level of incisors in adult Indian population.
There were 25 patients each in the conventional group and the ultrasound group. Conventional method includes auscultation and end tidal capnography. In the ultrasound group the upper end of the endotracheal tube cuff was positioned with an intent to provide 4 cm distance from the tube tip to the carina. X ray was used in both groups for confirmation of tip position and comparison between the two groups. Further repositioning of the tube was done if indicated and the mean length of the tube at incisors was then measured.
After x ray confirmation, endotracheal tube repositioning was required in 24% of patients in the USG group and 40 % of patients in the conventional group. However, this result was not found to be statistically significant (p = 0.364). The endotracheal tube length at the level of teeth was 19.4 ± 1.35 cm among females and 20.95 ± 1.37 cm among males.
Ultrasonography is a reliable method to determine ETT position in the trachea. There was no statistically significant difference when compared to the conventional method. The average length of ETT at the level of incisors was 19.5 cm for females and 21 cm for males.
气道超声在气管插管的正确定位中应用越来越广泛。我们假设借助超声可以实现气管导管尖端与隆突之间的安全距离。
我们的主要目标是确定在导管尖端最佳定位方面，与传统方法相比，超声引导下可视化气管导管套囊近端是否更佳。次要目标是找出成年印度人群中气管导管在门齿水平的最佳位置。
传统组和超声组各有25例患者。传统方法包括听诊和呼气末二氧化碳监测。在超声组中，气管导管套囊的上端定位时意图使导管尖端与隆突之间的距离为4厘米。两组均使用X射线来确认尖端位置并进行两组之间的比较。如有必要，对导管进行进一步重新定位，然后测量门齿处导管的平均长度。
经X射线确认后，超声组24%的患者需要重新定位气管导管，传统组为40%的患者。然而，这一结果未发现具有统计学意义（p = 0.364）。女性门齿处气管导管长度为19.4±1.35厘米，男性为20.95±1.37厘米。
超声检查是确定气管内导管在气管中位置的可靠方法。与传统方法相比，没有统计学上的显著差异。女性门齿处气管内导管的平均长度为19.5厘米，男性为21厘米。
