Intubation, Intratracheal
Conditions
Keywords
Lung ultrasound, Sliding lung, Probe position
Brief summary
The purpose of this study is to evaluate the diagnostic qualities of lung ultrasonography to monitor the position of the intubation probe. The primary assessment criterion is of study the position of the intubation probe with two examinations carried out independently : * sonography * chest radiography A correct position of the intubation probe will be considered if there is : * Highlighting of the extremity of the intubation probe in endo tracheal * Highlighting bilateral lung sliding
Detailed description
Oesophageal intubation can cause death. Selective intubation can induce a poor ventilation, hypoxemia, atelectasis etc… It's not rare in paediatric intubation. The prevalence of malposition of endotracheal tube is 30 to 40% in babies and infants less than 1 year old. Currently doctors try to detect malposition of intra-tracheal tube by auscultation and capnograms and chest radiography is needed to confirm it. The Chest X ray is the gold standard. The aim of the study is to confirm the good positioning of the tube with a lung ultrasonography. After each intra-tracheal intubation, for patients with qualifying criteria, a lung ultrasonography will be performed, in bed, by two trained doctors (senior and junior) to determine if the position is right. Then, the chest radiography will be performed as usual.
Interventions
OTHERlung ultrasound
Sponsors
URC-CIC Paris Descartes Necker Cochin
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Days to 18 Years
Healthy volunteers
No
Inclusion criteria
* Patient less than 18 years old * Patient intubated and ventilated * intubation probe considered in place on auscultation * SpO2\> 92% * Affiliate or entitled to a social security scheme * No opposition of any of the parents.
Exclusion criteria
* Children too unstable : decompensated shock * Spontaneous pneumothorax * Heart massage ongoing * Chest trauma * Faulty position of the probe intubation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of the position of intubation probe by comparison between chest radiography and lung ultrasonography | day of enrollment | correct position is defined by : * visualization of the probe intubation extremity in endotracheal * visualization of bilateral lung sliding |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of mobilized intubation probes | day of enrollment | Due to inefficient ventilation and despite undetected malposition |
| Number of malpositions of the intubation probe evaluated with lung ultrasonography by junior evaluator | day of enrollment | — |
| Number of patients with malposition of the oesophageal or selective intubation probe | day of enrollment | — |
| Number of malpositions of the intubation probe evaluated with a chest radiography by junior evaluator | day of enrollment | — |
| Number of malpositions of the intubation probe evaluated with a chest radiography by senior evaluator | day of enrollment | — |
| Number of malpositions of the intubation probe evaluated with lung ultrasonography by senior evaluator | day of enrollment | — |
Countries
France
Outcome results
None listed