Comparative study between tracheal ultrasound and pleural ultrasound for confirmation of endotracheal tube position

Abstract

Background and aim Ensuring the correct position of the endotracheal tube (ETT) at the right time can make a big difference in patient safety. Ultrasonography (USG) has become an essential element in the field of anesthesia and intensive care. The primary outcome of this study was to measure the time needed for confirmation of proper placement of ETT using tracheal ultrasonography (TUS) and pleural USG, whereas secondary outcome was evaluation the accuracy of USG for that purpose. Patients and methods This study was conducted on 80 patients with physical status American Society of Anesthesiologists I–II, aged 20–60 years, of both sexes, and subjected to elective surgery requiring ETT for general anesthesia. Patients were randomly assigned into two equal groups according to the ultrasound technique, which was used for identifying endotracheal intubation, in addition to routine use of auscultation and capnography in all patients. Groups are group T, in which USG was used for visualization of ‘comet tail sign,’ and group P, in which USG was used for visualization of ‘sliding lung sign’ on bilateral lung fields. The time needed for confirmation of tracheal intubation by USG, auscultation, and capnography was recorded for each group. Results The time needed by TUS in group T (7.90±0.84 s) was less than that needed by pleural ultrasound in group P [14.39±1.47 s (P<0.001)] and less than auscultation and capnography in both groups. The accuracy was 92.5 and 87.5% for USG technique in groups T and P, respectively. Conclusion USG is a rapid technique for identification of ETT placement. The time taken for detection of ETT position was less in case of TUS than other methods. Both tracheal and pleural ultrasounds are reliable methods in detecting the proper positioning of ETT.