Ultrasonographic lung sliding sign in confirming proper endotracheal intubation during emergency Intubation
| Autor: | Matthew Huei-Ming Ma, Kah-Meng Chong, Shih-Hung Liu, Shey-Yin Chen, Hao-Chang Chou, Chih-Hung Wang, Chien-Hua Huang, Shyr-Chyr Chen, Wan-Ching Lien, Zui-Shen Yen, Chiung-Yuan Hsu, Wei-Tien Chang, Shyh-Shyong Sim |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Point-of-Care Systems medicine.medical_treatment Transducers Taiwan Atelectasis Emergency Nursing Statistics Nonparametric Hospitals University Predictive Value of Tests Interquartile range Intubation Intratracheal medicine Humans Intubation Prospective Studies Airway Management Lung Ultrasonography Interventional Aged Aged 80 and over business.industry Tracheal intubation Middle Aged medicine.disease Heart Arrest Surgery Logistic Models Respiratory failure Predictive value of tests Anesthesia Emergency Medicine Female Airway management Respiratory Insufficiency Cardiology and Cardiovascular Medicine business Airway |
| Zdroj: | Resuscitation. 83:307-312 |
| ISSN: | 0300-9572 |
| Popis: | a b s t r a c t Aim of study: Unrecognized one-lung intubations (also known as main-stem intubation) can lead to hypoventilation, atelectasis, barotrauma, and even patient death. Many traditional methods can be employed to detect one-lung intubation; however, each of these methods has limitations and is not consistently reliable in emergency settings. This study aimed to assess the accuracy and timeliness of ultrasound to confirm proper endotracheal intubation. Methods: This was a prospective, single-center, observational study conducted at the emergency depart- ment of a national university teaching hospital. Patients received emergency tracheal intubation because of respiratory failure or cardiac arrest. After intubation, bedside ultrasound was performed with a trans- ducer placed on the chest bilaterally at the mid-axillary line, to identify lung sliding over the lungs bilaterally during ventilation. Chest radiography was used as the criterion standard for confirmation of endotracheal tube position. Results: One hundred and fifteen patients needing tracheal intubation were included, and nine (7.8%) had one-lung intubations. The overall accuracy of ultrasound to confirm proper endotracheal intubation was 88.7% (95% confidence interval (CI): 81.6-93.3%). The positive predictive value was 94.7% (95% CI: 87.1-97.9%) in the non-cardiac-arrest group and 100% (95% CI: 87.1-100.0%) in the cardiac-arrest group. The median operating time of ultrasound was 88 s (interquartile range (IQR): 55.0, 193.0), and of chest radiography was 1349 s (IQR: 879.0, 2221.0) post intubation. Conclusions: In this study, the positive predictive value of bilateral lung sliding in confirming proper endo- tracheal intubation was high, especially among patients with cardiac arrest. Considerable time advantage of ultrasound over chest radiography was demonstrated. |
| Databáze: | OpenAIRE |
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