Ultrasound assessment of endotracheal tube depth in neonates: a prospective feasibility study.
Arch Dis Child Fetal Neonatal Ed
; 109(1): 94-99, 2023 Dec 15.
Article
em En
| MEDLINE
| ID: mdl-37553228
ABSTRACT
OBJECTIVE:
To examine the reliability of a novel ultrasound (US) method for assessment of endotracheal tube (ETT) position in neonates.DESIGN:
Prospective, observational, single-centre, feasibility study.SETTING:
Level III neonatal intensive care unit. PATIENTS Term and preterm neonates requiring endotracheal intubation. INTERVENTION US measurement of the ETT tip to right pulmonary artery (RPA) distance was used to determine ETT position according to one-fourth to three-fourths estimated tracheal length for weight. US demonstration of pleural sliding and diaphragmatic movement was also assessed. Chest radiography (CXR) was performed following each intubation. MAIN OUTCOMEMEASURES:
Agreement between US assessment of ETT tip position and CXR served as the gold standard. Sensitivity, specificity, positive and negative predictive values for each US method and correlation between ETT tip to RPA distance on US, and ETT tip to carina distance on CXR were assessed.RESULTS:
Forty-two US studies were performed on 33 intubated neonates. US evaluation of ETT-RPA distance identified 100% of ETTs positioned correctly 77% deep and 80% high, demonstrating strong agreement with CXR (kappa=0.822). Sensitivity was 78%, specificity 100%, positive predictive value 100% and negative predictive value 86%. US ETT-RPA distance strongly correlated with CXR ETT-carina distance (r=0.826). No significant agreement was found between CXR and US assessment of pleural sliding and diaphragmatic movement. No adverse events were encountered during US scans.CONCLUSION:
US evaluation of ETT-RPA distance demonstrated excellent accuracy for determining ETT position in neonates compared with CXR. More research is needed to support its feasibility in clinical settings.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Traqueia
/
Intubação Intratraqueal
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
/
Newborn
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article