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Temporal comparison of ultrasound vs. auscultation and capnography in verification of endotracheal tube placement.
Acta Anaesthesiol Scand. 2011 Nov; 55(10):1190-5.AA

Abstract

BACKGROUND

This study compared the time consumption of bilateral lung ultrasound with auscultation and capnography for verifying endotracheal intubation.

METHODS

A prospective, paired, and investigator-blinded study carried out in the operating theatre. Twenty-five adult patients requiring endotracheal intubation were included. During intubation, transtracheal ultrasound was performed to visualize passage of the endotracheal tube. During bag ventilation, bilateral lung ultrasound was performed for the detection of lung sliding as a sign of ventilation simultaneous with capnography and auscultation of the epigastrium and chest. Primary outcome measure was time difference to confirmed endotracheal intubation between ultrasound and auscultation alone. Secondary outcome measure was time difference between ultrasound and auscultation combined with capnography.

RESULTS

Both methods verified endotracheal tube placement in all patients. In 68% of patients, endotracheal tube placement was visualized by real-time transtracheal ultrasound. Comparing ultrasound with the combination of auscultation and capnography, there was a significant difference between the two methods. Median time for ultrasound was 40 s [interquartile range (IQR) 35-48 s] vs. 48 s (IQR 45-53 s), P < 0.0001. Mean difference was -7.1 s in favour of ultrasound [95% confidence interval (CI) -9.4--4.8 s]. No significant difference was found between ultrasound compared with auscultation alone. Median time for auscultation alone was 42 s (IQR 37-47 s), P = 0.6, with a mean difference of -0.88 s in favour of ultrasound (95% CI -4.2-2.5 s).

CONCLUSIONS

Verification of endotracheal tube placement with ultrasound is as fast as auscultation alone and faster than the standard method of auscultation and capnography.

Authors+Show Affiliations

Akutcentrum/Anestesikliniken, Skåne University Hospital, SUS, Malmø, Sweden. ptrpfffr@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22092123

Citation

Pfeiffer, P, et al. "Temporal Comparison of Ultrasound Vs. Auscultation and Capnography in Verification of Endotracheal Tube Placement." Acta Anaesthesiologica Scandinavica, vol. 55, no. 10, 2011, pp. 1190-5.
Pfeiffer P, Rudolph SS, Børglum J, et al. Temporal comparison of ultrasound vs. auscultation and capnography in verification of endotracheal tube placement. Acta Anaesthesiol Scand. 2011;55(10):1190-5.
Pfeiffer, P., Rudolph, S. S., Børglum, J., & Isbye, D. L. (2011). Temporal comparison of ultrasound vs. auscultation and capnography in verification of endotracheal tube placement. Acta Anaesthesiologica Scandinavica, 55(10), 1190-5. https://doi.org/10.1111/j.1399-6576.2011.02501.x
Pfeiffer P, et al. Temporal Comparison of Ultrasound Vs. Auscultation and Capnography in Verification of Endotracheal Tube Placement. Acta Anaesthesiol Scand. 2011;55(10):1190-5. PubMed PMID: 22092123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Temporal comparison of ultrasound vs. auscultation and capnography in verification of endotracheal tube placement. AU - Pfeiffer,P, AU - Rudolph,S S, AU - Børglum,J, AU - Isbye,D L, Y1 - 2011/09/08/ PY - 2011/06/26/accepted PY - 2011/11/19/entrez PY - 2011/11/19/pubmed PY - 2012/3/14/medline SP - 1190 EP - 5 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 55 IS - 10 N2 - BACKGROUND: This study compared the time consumption of bilateral lung ultrasound with auscultation and capnography for verifying endotracheal intubation. METHODS: A prospective, paired, and investigator-blinded study carried out in the operating theatre. Twenty-five adult patients requiring endotracheal intubation were included. During intubation, transtracheal ultrasound was performed to visualize passage of the endotracheal tube. During bag ventilation, bilateral lung ultrasound was performed for the detection of lung sliding as a sign of ventilation simultaneous with capnography and auscultation of the epigastrium and chest. Primary outcome measure was time difference to confirmed endotracheal intubation between ultrasound and auscultation alone. Secondary outcome measure was time difference between ultrasound and auscultation combined with capnography. RESULTS: Both methods verified endotracheal tube placement in all patients. In 68% of patients, endotracheal tube placement was visualized by real-time transtracheal ultrasound. Comparing ultrasound with the combination of auscultation and capnography, there was a significant difference between the two methods. Median time for ultrasound was 40 s [interquartile range (IQR) 35-48 s] vs. 48 s (IQR 45-53 s), P < 0.0001. Mean difference was -7.1 s in favour of ultrasound [95% confidence interval (CI) -9.4--4.8 s]. No significant difference was found between ultrasound compared with auscultation alone. Median time for auscultation alone was 42 s (IQR 37-47 s), P = 0.6, with a mean difference of -0.88 s in favour of ultrasound (95% CI -4.2-2.5 s). CONCLUSIONS: Verification of endotracheal tube placement with ultrasound is as fast as auscultation alone and faster than the standard method of auscultation and capnography. SN - 1399-6576 UR - https://www.unboundmedicine.com/medline/citation/22092123/Temporal_comparison_of_ultrasound_vs__auscultation_and_capnography_in_verification_of_endotracheal_tube_placement_ L2 - https://doi.org/10.1111/j.1399-6576.2011.02501.x DB - PRIME DP - Unbound Medicine ER -