Endotracheal Tube, Intensive Care Patients, Two Bedside, Ultrasound
Conditions
Brief summary
This cross-sectional observational study aims to predict the sensitivity and specificity of ultrasonography using suprasternal and subxiphoid methods to confirm the correct placement of endotracheal tubes compared to standard methods in intensive care patients.
Detailed description
Endotracheal intubation is the primary medical procedure used for securing the airway, confirmation of endotracheal tube (ETT) placement is essential to prevent hypoxia and aspiration. The best primary approach to confirm endotracheal tube placement is observation of the tube passage through the vocal cords followed by assessment based on chest and epigastric auscultation. Ultrasound machines are now increasingly available in emergency departments and intensive care units. It is a non-invasive, portable and serves as a real-time diagnostic tool with rapid and accurate results.
Interventions
DEVICEUltrasound using suprasternal method
The research resident will perform suprasternal ultrasound (US) with a curvilinear probe) C6-2) of US machine (Philips Affiniti 50) which will be placed transversely on the suprasternal area just above to the suprasternal notch immediately after intubation, The position of the trachea will be determined by a hyperechoic air-mucosa (A-M) interface with reverberation artifact posteriorly (comet-tail artifact). The position of endotracheal tube (ETT), when it is placed in trachea, will be defined as observable contour between A-M and comet-tail artifact. If the second contour appears, it will be similar to the second airway which is called double-tract sign which means that the ETT will be in the esophagus. (7) If the position of the esophagus is suspected of being exactly behind the trachea, operator of ultrasound can specify the location of the esophagus by moving the probe to the left and right sides during scan.
DEVICEUltrasound using subxiphoid method
Immediately after suprasternal sonography, the research resident will perform subxiphoid sonography to detect diaphragmatic motion, and information will be recorded.
Sponsors
Tanta University
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients \> 18 years old. * Both sex. * All patients requiring prophylactic airway management e.g (patient with Glasgow Coma Scale \<8) with endotracheal intubation in the intensive care unit.
Exclusion criteria
* An abnormal airway anatomy. * Tracheal or endobronchial lesion. * Significant cervical trauma. * Cervical abnormality. * Neck swelling. * Patients who need cardiopulmonary resuscitation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Accuracy to predict correct placement | 5 minutes after placement of endotracheal tube | Accuracy in predicting the correct placement of the endotracheal tube will be assessed using Sensitivity and Specificity, positive predictive value (PPV), and negative predictive value (NPV) for each ultrasound technique. |
Countries
Egypt
Contacts
Primary ContactEman E Abuharga, MBBCH
Outcome results
None listed