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2014 ; 14
(59
): 362-6
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Laryngo-tracheal ultrasonography to confirm correct endotracheal tube and
laryngeal mask airway placement
#MMPMID26672974
Wojtczak JA
; Cattano D
J Ultrason
2014[Dec]; 14
(59
): 362-6
PMID26672974
show ga
Waveform capnography was recommended as the most reliable method to confirm
correct endotracheal tube or laryngeal mask airway placements. However,
capnography may be unreliable during cardiopulmonary resuscitation and during low
flow states. It may lead to an unnecessary removal of a well-placed endotracheal
tube, re-intubation and interruption of chest compressions. Real-time upper
airway (laryngo-tracheal) ultrasonography to confirm correct endotracheal tube
placement was shown to be very useful in cadaveric models and during emergency
intubation. Tracheal ultrasonography does not interrupt chest compressions and is
not affected by low pulmonary flow or airway obstruction, but is limited by
ultrasonography scattering and acoustic artifacts generated in air - mucosa
interfaces. Sonographic upper airway assessment emerges as a rapid and easily
available method to predict difficult intubation, to assess the laryngeal and
hypopharyngeal size and visualize the position of the laryngeal mask airway in
situ. This study demonstrates that the replacement of air with saline in
endotracheal tube or laryngeal mask airway cuffs and the use of the contrast
agents enables detection of cuffs in the airway. It also allows visualization of
the surrounding structures or tissues as the ultrasound beam can be transmitted
through the fluid - filled cuffs without being reflected from air - mucosal
interfaces.