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J Crit Care ; 28(5): 675-80, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23806246

RESUMO

PURPOSE: The purpose of this study is to determine the diagnostic accuracy of portable ultrasound for detection of laryngeal edema (LE) in intubated patients. MATERIALS AND METHODS: We conducted a prospective, observational study from December 2010 to September 2011. We measured air column width differences (ACWD) in planned extubation patients admitted in intensive care unit by ultrasound. The primary outcome was the diagnostic accuracy of ACWD to predict the presence of LE. RESULTS: A total of 101 patients were enrolled. The prevalence of LE was 16.8%. Baseline characteristics were similar between intubated patients with and without LE. The mean difference of increasing of air column width in patients without LE was higher than in LE group (1.9 vs 1.08 mm, P<.001). The sensitivity and specificity at ACWD higher or equal to 1.6 mm were 0.706 and 0.702, respectively. The positive predictive value and negative predictive value were 0.324 and 0.922, respectively. The area under the receiver operating characteristic curve of laryngeal ultrasound was 0.823 (95% confidence interval, 0.698-0.947) and that of cuff leak test was 0.840 (95% confidence interval, 0.715-0.964). CONCLUSION: Portable intensive care unit ultrasound visualizing ACWD between predeflation and postdeflation cuff balloon is a promising objective tool, which aids in prediction of successful extubation regarding LE.


Assuntos
Intubação Intratraqueal/efeitos adversos , Edema Laríngeo/diagnóstico por imagem , Edema Laríngeo/etiologia , Sistemas Automatizados de Assistência Junto ao Leito , Idoso , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Sensibilidade e Especificidade , Ultrassonografia
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