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Tracheal rapid ultrasound exam (T.R.U.E.) for confirming endotracheal tube placement during emergency intubation.
Resuscitation. 2011 Oct; 82(10):1279-84.R

Abstract

OBJECTIVES

This study aimed to assess the diagnostic accuracy and timeliness of using tracheal ultrasound to examine endotracheal tube placement during emergency intubation.

METHODS

This was a prospective, observational study, conducted at the emergency department of a national university teaching hospital. Patients received emergency intubation because of impending respiratory failure, cardiac arrest, or severe trauma. The tracheal rapid ultrasound exam (T.R.U.E.) was performed during emergency intubation with the transducer placed transversely at the trachea over the suprasternal notch. Quantitative waveform capnography was used as the criterion standard for confirmation of tracheal intubation. The main outcome was the concordance between the T.R.U.E. and the capnography.

RESULTS

A total of 112 patients were included in the analysis, and 17 (15.2%) had esophageal intubations. The overall accuracy of the T.R.U.E. was 98.2% (95% confidence interval [CI]: 93.7-99.5%). The kappa (κ) value was 0.93 (95% CI: 0.84-1.00), indicating a high degree of agreement between the T.R.U.E. and capnography. The sensitivity, specificity, positive predictive value, and negative predictive value of the T.R.U.E. were 98.9% (95% CI: 94.3-99.8%), 94.1% (95% CI: 73.0-99.0%), 98.9% (95% CI: 94.3-99.8%) and 94.1% (95% CI: 73.0-99.0%). The median operating time of the T.R.U.E. was 9.0s (interquartile range [IQR]: 6.0, 14.0).

CONCLUSIONS

The application of the T.R.U.E. to examine endotracheal tube placement during emergency intubation is feasible, and can be rapidly performed.

Authors+Show Affiliations

Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. erichaochang@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

21684668

Citation

Chou, Hao-Chang, et al. "Tracheal Rapid Ultrasound Exam (T.R.U.E.) for Confirming Endotracheal Tube Placement During Emergency Intubation." Resuscitation, vol. 82, no. 10, 2011, pp. 1279-84.
Chou HC, Tseng WP, Wang CH, et al. Tracheal rapid ultrasound exam (T.R.U.E.) for confirming endotracheal tube placement during emergency intubation. Resuscitation. 2011;82(10):1279-84.
Chou, H. C., Tseng, W. P., Wang, C. H., Ma, M. H., Wang, H. P., Huang, P. C., Sim, S. S., Liao, Y. C., Chen, S. Y., Hsu, C. Y., Yen, Z. S., Chang, W. T., Huang, C. H., Lien, W. C., & Chen, S. C. (2011). Tracheal rapid ultrasound exam (T.R.U.E.) for confirming endotracheal tube placement during emergency intubation. Resuscitation, 82(10), 1279-84. https://doi.org/10.1016/j.resuscitation.2011.05.016
Chou HC, et al. Tracheal Rapid Ultrasound Exam (T.R.U.E.) for Confirming Endotracheal Tube Placement During Emergency Intubation. Resuscitation. 2011;82(10):1279-84. PubMed PMID: 21684668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tracheal rapid ultrasound exam (T.R.U.E.) for confirming endotracheal tube placement during emergency intubation. AU - Chou,Hao-Chang, AU - Tseng,Wen-Pin, AU - Wang,Chih-Hung, AU - Ma,Matthew Huei-Ming, AU - Wang,Hsiu-Po, AU - Huang,Pei-Chuan, AU - Sim,Shyh-Shyong, AU - Liao,Yen-Chen, AU - Chen,Shey-Yin, AU - Hsu,Chiung-Yuan, AU - Yen,Zui-Shen, AU - Chang,Wei-Tien, AU - Huang,Chien-Hua, AU - Lien,Wan-Ching, AU - Chen,Shyr-Chyr, Y1 - 2011/06/01/ PY - 2011/02/25/received PY - 2011/05/10/revised PY - 2011/05/14/accepted PY - 2011/6/21/entrez PY - 2011/6/21/pubmed PY - 2012/2/2/medline SP - 1279 EP - 84 JF - Resuscitation JO - Resuscitation VL - 82 IS - 10 N2 - OBJECTIVES: This study aimed to assess the diagnostic accuracy and timeliness of using tracheal ultrasound to examine endotracheal tube placement during emergency intubation. METHODS: This was a prospective, observational study, conducted at the emergency department of a national university teaching hospital. Patients received emergency intubation because of impending respiratory failure, cardiac arrest, or severe trauma. The tracheal rapid ultrasound exam (T.R.U.E.) was performed during emergency intubation with the transducer placed transversely at the trachea over the suprasternal notch. Quantitative waveform capnography was used as the criterion standard for confirmation of tracheal intubation. The main outcome was the concordance between the T.R.U.E. and the capnography. RESULTS: A total of 112 patients were included in the analysis, and 17 (15.2%) had esophageal intubations. The overall accuracy of the T.R.U.E. was 98.2% (95% confidence interval [CI]: 93.7-99.5%). The kappa (κ) value was 0.93 (95% CI: 0.84-1.00), indicating a high degree of agreement between the T.R.U.E. and capnography. The sensitivity, specificity, positive predictive value, and negative predictive value of the T.R.U.E. were 98.9% (95% CI: 94.3-99.8%), 94.1% (95% CI: 73.0-99.0%), 98.9% (95% CI: 94.3-99.8%) and 94.1% (95% CI: 73.0-99.0%). The median operating time of the T.R.U.E. was 9.0s (interquartile range [IQR]: 6.0, 14.0). CONCLUSIONS: The application of the T.R.U.E. to examine endotracheal tube placement during emergency intubation is feasible, and can be rapidly performed. SN - 1873-1570 UR - https://www.unboundmedicine.com/medline/citation/21684668/Tracheal_rapid_ultrasound_exam__T_R_U_E___for_confirming_endotracheal_tube_placement_during_emergency_intubation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0300-9572(11)00331-5 DB - PRIME DP - Unbound Medicine ER -