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Twit Text #
English Wikipedia
Evaluation of real-time tracheal ultrasound versus colorimetric capnography as a
point of care tool for confirmation of endotracheal intubation: a randomized
controlled study
#MMPMIDC7682118
Abdelrahman TN
; Abdelhameed GA
; Armanious SH
ä-/-ä 2020[]; 12
(1
): ä PMIDC7682118
show ga
BACKGROUND: Endotracheal intubation is essential for optimal airway control
during general anesthesia or resuscitation of critically ill patients.
Misplacement of the endotracheal tube (ETT) can lead to devastating, preventable
morbidity and mortality. Colorimetric carbon dioxide detectors are considered a
simplistic mainstream capnography that contains a pH-sensitive chemical marker
that is prone to color change with ventilation. Real-time tracheal ultrasound
allows for the dynamic observation of tube passage through the trachea or the
esophagus, providing immediate confirmation of placement prior to any ventilation
attempts with reported sensitivity/specificity of 100% for adult patients in the
operating room. We aimed to compare two different techniques (tracheal real-time
ultrasound vs colorimetric capnography) as point of care tools for confirmation
of correct endotracheal tube position. RESULTS: This study carried out on
eligible seventy patients undergoing general anesthesia. Patients were divided
randomly and equally into two groups (35 patients each). Group A in which
patients? ETT position was confirmed by real-time tracheal ultrasound and group B
in which patients? ETT position was confirmed by colorimetric capnography.
Comparing both groups according to their diagnostic performance for detecting the
correct position of the ETT inserted showed the diagnostic sensitivity,
specificity, and accuracy of real-time tracheal ultrasound vs colorimetric
capnography (93.8%, 66.7%, and 91.4% VS 97%, 50%, and 94.3% respectively).
Although there were higher sensitivity and accuracy of colorimetric capnography
than real-time tracheal ultrasound, the p value between the two groups was 0.462.
CONCLUSION: Both tools are fast, effective, reliable, and accurate with many
advantages and few disadvantages including the need for training on ultrasound
practice and air-filled stomach in colorimetric capnography. However, these
disadvantages can be easily overruled and the benefits from both tools overweigh
their disadvantages.