Endotracheal Tube, Mechanical Ventilation, Preterm Neonates
Conditions
Keywords
tracheal ultrasound in preterm neonates for ETT confirmation
Brief summary
Improper placement of the endotracheal tube during intubation can lead to dangerous complications. It has been reported that chest radiography is the gold standard method for validation of endotracheal tube (ET) position . This study will compare the effectiveness of endotracheal tube position obtained by ultrasonography vs that obtained by chest X-ray with two operators an expert and a trainee in preterm neonates. This study will work to the extent that the trainee has the ability to do sonar for premature babies with the same efficiency as an ultrasound specialist.
Detailed description
neonate in the neonatal intensive care unit (NICU) are intubated for different reasons and most of these patients undergo chest X-rays (CXRs) several times during their ICU admission to confirm endotracheal tube (ETT) placement, monitor severity of cardiopulmonary illness, and detect complications of other indwelling devices Although the amount of radiation exposure is minimal with CXRs, exposure to multiple CXRs in NICU patients, especially in preterm, results in accumulated radiation burden over time. This can lead to tissue damage and is associated with an increased risk of malignancy Tracheal ultrasonography is technique for confirmation of proper endotracheal intubation. Potential advantages include detection of both main stem and esophageal intubation and less time to image availability than CXR and less radiation Point of care ultrasound (POCUS) of the anterior neck is increasingly used by emergency physicians and anesthesiologists to detect endotracheal and esophageal intubation. It is more accurate and faster than physical examination and capnography, with adult meta-analyses reporting that it has sensitivities of 93-98%, specificities of 97-98% We will explore effectiveness and reproducibility of tracheal ultrasonography done by in hospital neonatologist trainee in the technique vs the expert radiologist in determination of ET position.
Interventions
DIAGNOSTIC_TESTtracheal ultrasound ( expert radiologist)
tracheal ultrasound, performed by expert radiologist, for preterm neonates for confirmation of ETT site
DIAGNOSTIC_TESTtracheal ultrasound by trainee neonatologist
tracheal ultrasound, performed by trainee neonatologist ( after receiving training for the procedure) , for preterm neonates for confirmation of ETT site
DIAGNOSTIC_TESTChest x-ray
chest xray done for confirmation of ETT site
Sponsors
Ain Shams University
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
DIAGNOSTIC
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
1 Hours to 30 Days
Healthy volunteers
No
Inclusion criteria
* Less than 35weeks gestational age * Invasive mechanical ventilation via ETT.
Exclusion criteria
* Upper air way anomalies. * eligible patients whose care team deemed enrollment will disrupt patient care.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| time in minutes to receive tracheal ultrasound by trainee neonatologist results for ETT site | 24 hours | Time taken from giving order to perform the tracheal ultrasound by trainee neonatologist to receiving the results of the imaging |
| time in minutes to receive CXR results for ETT site | 24 hours | Time taken from giving order to perform chest x ray to receiving the results of the imaging |
| time in minutes to receive tracheal ultrasound by expert radiologist results for ETT site | 24 hours | Time taken from giving order to perform the tracheal ultrasound by expert radiologist to receiving the results of the imaging |
| reproducibility of results between CXR , expert and trainee tracheal ultrasound | 24 hours | Accuracy of the findings of the tracheal ultrasound by expert, trainee and chest x ray for the same patient |
Countries
Egypt
Outcome results
None listed