Accuracy and Precision of an Optoacoustic Prototype in Determining Endotracheal Tube Position in Children
| Autor: | Michael T. Bigham, Donald S. Prough, Neil L. McNinch, Yuriy Petrov, Teresa A Volsko, Clark R Anderson |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Accuracy and precision Radiography medicine.medical_treatment Pilot Projects Critical Care and Intensive Care Medicine Photoacoustic Techniques 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Intubation Intratracheal medicine Humans Prospective Studies Child Tip position Endotracheal tube medicine.diagnostic_test business.industry Ultrasound Tracheal intubation Infant Newborn Infant Reproducibility of Results General Medicine Trachea Position (obstetrics) 030228 respiratory system Child Preschool Female business Nuclear medicine Chest radiograph |
| Zdroj: | Respiratory Care. 63:1463-1470 |
| ISSN: | 1943-3654 0020-1324 |
| Popis: | BACKGROUND: Confirmation of endotracheal tube (ETT) tip position and timely identification and correction of malposition is an essential component of care for endotracheally intubated and mechanically ventilated children. We evaluated the ability of a prototype optoacoustic medical device to determine ETT tip position. We hypothesized that the precision of optoacoustic assessment of ETT tip position would be comparable to chest radiography. METHODS: We recruited children aged newborn to 16 y who were admitted to the pediatric ICU requiring tracheal intubation and undergoing a chest radiograph for clinical purposes. After positioning each child on a chest radiograph plate, a sterile optical fiber, temporarily inserted through the ETT, emitted laser pulses perpendicular to the fiber and to the ETT, generating acoustic (ultrasound) waves in overlying tissue when the tip of the fiber passed beneath an acoustic sensor in the sternal notch. The distance from the ETT tip to the peak acoustic signal was used to calculate the distance from the ETT tip to the carina, which was compared with the same distance calculated by the radiologist reading the chest radiograph. Pearson9s correlation coefficient, paired t tests, a Bland-Altman plot were used to compare the measures (P RESULTS: Twenty-six subjects were enrolled: 15 (57.7%) were male, median (interquartile range) age, weight, and height were 9 months (4–24), 9.6 kg (5.7–13.0), and 75 cm (62–90), respectively. All ETTs were cuffed (internal diameter range 3.0–5.0 mm). The relationship between optoacoustic and chest radiograph measurements was strong (r = 0.91, P CONCLUSIONS: The optoacoustic prototype accurately determined ETT tip position and was comparable in precision to chest radiograph. |
| Databáze: | OpenAIRE |
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