Validation of tracheal intubation of wire-reinforced endotracheal tube with ultrasonography

Abstract

Objective. The use of ultrasonography (US) is a new method for verifying the location of the endotracheal tube. Design. Our study was designed as a paired-data and investigator-blind clinical study for evaluating the effectiveness of US for verification of wire-reinforced endotracheal tube (WR-ETT) placement compared with capnography. Setting. This study was conducted on 56 patients scheduled for elective surgery under general anesthesia. Patients. Fifty patients completed the study as 6 were excluded for various reasons. Intervention. Two different investigators performed the ultrasonography and intubation independently from one another. While investigator 1 attempted to verify the location of the WR-ETT with a portable ultrasonography with sagittal trans-tracheal view, investigator 2 intubated the patient and verified the location of the ETT using capnography. Measurements. Time for verifying the location of the ETT using both US and capnography was recorded. Main Results. When the ultrasonography method was compared with capnography for verification of the WR-ETT placement, the results showed 95.75% sensitivity and 100% specificity. The average verification times for endotracheal intubation were 12.78 ± 7.46 s. and 24.44 ± 1.45 s. with US and capnography, respectively (p=0.003). Conclusion. Our results suggest that ultrasound identification of a WR-ETT within the trachea is a rapid and accurate method for confirmation of tracheal placement. Larger studies are needed before widespread use of this technique.