Original Articles
Rapid confirmation of endo-tracheal tube placement by upper airway ultrasonography and end-tidal capnography in pediatric patients requiring intubation in PICU and operation theateres | |
Dr. Sanjay K.G., Dr. Vishwanath.K.G, Dr. Arun.M.A, Dr. Neelam Meena, Dr. Jitendra, Dr. Naveen P., Dr. Deepak Meena, Dr. Deepika Meena | |
Introduction: Over the past few years, ultrasonography is increasingly being used to confirm the correct placement of endotracheal tube (ETT). In our study, we aimed to compare the rapidity of endotracheal tube placement confirmation by USG and continuous wave capnography. Two primary outcomes were measured in our study. First was the time taken for each method to confirm tube placement. The second primary outcome assessed was the sensitivity and specificity of ultrasonography against the continuous wave capnography to confirm endotracheal intubation. Methodology: This is a single centered, prospective observational study conducted in the Department of Anaesthesiology, Dr. S. N. Medical College, Jodhpur. 40 study subjects included aged 5 to 14 years of ASA classification I and II with 24 males and 16 females. The intubation was performed as per standard hospital protocol. As part of the study protocol, ultrasonography was used to identify ETT placement simultaneously with the quantitative waveform capnography (end‑tidal carbon dioxide). Confirmation of tube placement and time taken for the same were noted by two separate anaesthesiologists. Results: Out of the 40 intubation attempts, one (2.5%) had esophageal intubation. The sensitivity and specificity of diagnosis using ultrasonography were 100% and 100%, respectively. The time taken to confirm tube placement with ultrasonography was 18.4 ± 3.99 sec. compared to waveform capnography which was 21.12 ± 0.79 sec. The time taken by ultrasonography was significantly less and the difference between mean time of two methods is statistically significant (p≤0.001). Conclusions: Ultrasonography confirmed tube placement with equal sensitivity and specificity to quantitative waveform capnography. But then, it yielded results considerably faster than the quantitative waveform capnography. |
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