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Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit

OBJECTIVE: Critically ill patients often require emergency endotracheal intubation and mechanical ventilation. When esophageal intubation is not confirmed early, treatment may be delayed, even for life-threatening conditions. We examined the accuracy of bedside real-time airway ultrasonography in co...

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Autores principales: Chen, Weiting, Chen, Junbo, Wang, Hehao, Chen, Yingzi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783275/
https://www.ncbi.nlm.nih.gov/pubmed/31880180
http://dx.doi.org/10.1177/0300060519894771
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author Chen, Weiting
Chen, Junbo
Wang, Hehao
Chen, Yingzi
author_facet Chen, Weiting
Chen, Junbo
Wang, Hehao
Chen, Yingzi
author_sort Chen, Weiting
collection PubMed
description OBJECTIVE: Critically ill patients often require emergency endotracheal intubation and mechanical ventilation. When esophageal intubation is not confirmed early, treatment may be delayed, even for life-threatening conditions. We examined the accuracy of bedside real-time airway ultrasonography in confirming the endotracheal tube (ETT) position during emergency endotracheal intubation in patients in the intensive care unit (ICU). METHODS: This single-center prospective observational study included 118 patients who underwent urgent endotracheal intubation in the ICU of Taizhou Hospital of Integrated Traditional Chinese and Western Medicine. Tracheal ultrasonography was used to confirm the ETT position during endotracheal intubation, after which fiberoptic bronchoscopy was performed. The accuracy of bedside real-time tracheal ultrasonography in determining the ETT position was examined. RESULTS: Twelve (10.2%) patients underwent endotracheal intubation. The kappa value was 0.844, indicating perfect consistency between tracheal ultrasonography and fiberoptic bronchoscopy in identifying esophageal intubation. The sensitivity, specificity, and positive and negative predictive values of tracheal ultrasonography in determining the ETT position were 75.0%, 100%, 100%, and 97.2%, respectively. CONCLUSIONS: Bedside real-time tracheal ultrasonography accurately assesses the ETT position in the ICU and can identify the ETT position during intubation. These findings have important clinical applications and are of great significance for treatment of ICU patients.
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spelling pubmed-77832752021-01-13 Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit Chen, Weiting Chen, Junbo Wang, Hehao Chen, Yingzi J Int Med Res Prospective Clinical Research Report OBJECTIVE: Critically ill patients often require emergency endotracheal intubation and mechanical ventilation. When esophageal intubation is not confirmed early, treatment may be delayed, even for life-threatening conditions. We examined the accuracy of bedside real-time airway ultrasonography in confirming the endotracheal tube (ETT) position during emergency endotracheal intubation in patients in the intensive care unit (ICU). METHODS: This single-center prospective observational study included 118 patients who underwent urgent endotracheal intubation in the ICU of Taizhou Hospital of Integrated Traditional Chinese and Western Medicine. Tracheal ultrasonography was used to confirm the ETT position during endotracheal intubation, after which fiberoptic bronchoscopy was performed. The accuracy of bedside real-time tracheal ultrasonography in determining the ETT position was examined. RESULTS: Twelve (10.2%) patients underwent endotracheal intubation. The kappa value was 0.844, indicating perfect consistency between tracheal ultrasonography and fiberoptic bronchoscopy in identifying esophageal intubation. The sensitivity, specificity, and positive and negative predictive values of tracheal ultrasonography in determining the ETT position were 75.0%, 100%, 100%, and 97.2%, respectively. CONCLUSIONS: Bedside real-time tracheal ultrasonography accurately assesses the ETT position in the ICU and can identify the ETT position during intubation. These findings have important clinical applications and are of great significance for treatment of ICU patients. SAGE Publications 2019-12-27 /pmc/articles/PMC7783275/ /pubmed/31880180 http://dx.doi.org/10.1177/0300060519894771 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Prospective Clinical Research Report
Chen, Weiting
Chen, Junbo
Wang, Hehao
Chen, Yingzi
Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit
title Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit
title_full Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit
title_fullStr Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit
title_full_unstemmed Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit
title_short Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit
title_sort application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit
topic Prospective Clinical Research Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783275/
https://www.ncbi.nlm.nih.gov/pubmed/31880180
http://dx.doi.org/10.1177/0300060519894771
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