Kadlimatti Deepak Vijaykumar, Bk Lekhashree, Sk Amithkumar, Iqbal Salim M, Balamreddy Kesa Sahithi
Department of Anaesthesia, Dr. B.R. Ambedkar Medical College and Hospital, Bangalore, IND.
Cureus. 2025 Jul 9;17(7):e87594. doi: 10.7759/cureus.87594. eCollection 2025 Jul.
This study compared the diagnostic accuracy and time efficiency of suprasternal versus subxiphoid ultrasonography for endotracheal tube (ETT) confirmation.
A prospective observational study was conducted on 50 patients classified as American Society of Anesthesiologists Physical Status (ASA-PS) 1 or 2 who were scheduled for elective surgical procedures under general anesthesia. After endotracheal intubation (ETI), tube placement was verified using three methods: suprasternal ultrasonography, visualizing the characteristic "bullet sign"; subxiphoid ultrasonography, assessing diaphragmatic motion; and continuous waveform capnography. The time required for confirmation and the diagnostic accuracy of each method were systematically recorded.
Suprasternal ultrasound was significantly faster (5.58 ± 1.14 seconds) than capnography (31.50 ± 4.84 seconds) (p < 0.001) and auscultation (33.38 ± 4.58 seconds) (p < 0.001). Subxiphoid ultrasound took 20.32 ± 4.60 seconds (p < 0.001). No false positives or false negatives were observed. Both ultrasound methods showed 100% agreement with capnography.
Suprasternal and subxiphoid ultrasonography are equally accurate but faster than capnography for ETT confirmation in low-risk surgical patients. Due to its speed, suprasternal ultrasound may be preferable in time-critical scenarios.
本研究比较了胸骨上超声与剑突下超声在确认气管内导管（ETT）时的诊断准确性和时间效率。
对50例美国麻醉医师协会身体状况分级（ASA-PS）为1或2级、计划在全身麻醉下进行择期外科手术的患者进行了一项前瞻性观察研究。气管插管（ETI）后，使用三种方法验证导管位置：胸骨上超声，观察特征性的“子弹征”；剑突下超声，评估膈肌运动；以及连续波形二氧化碳描记法。系统记录每种方法的确认所需时间和诊断准确性。
胸骨上超声（5.58±1.14秒）明显快于二氧化碳描记法（31.50±4.84秒）（p<0.001）和听诊（33.38±4.58秒）（p<0.001）。剑突下超声用时20.32±4.60秒（p<0.001）。未观察到假阳性或假阴性。两种超声方法与二氧化碳描记法的一致性均为100%。
在低风险手术患者中，胸骨上超声和剑突下超声在确认ETT时准确性相同，但比二氧化碳描记法更快。由于其速度快，胸骨上超声在时间紧迫的情况下可能更可取。
