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Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 4/2015

01-04-2015 | Review Article/Brief Review

Transtracheal ultrasound for verification of endotracheal tube placement: a systematic review and meta-analysis

Authors: Saurabh Kumar Das, MD, Nang Sujali Choupoo, MD, Rudrashish Haldar, MD, Amitabh Lahkar, MD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 4/2015

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Abstract

Purpose

Early confirmation of endotracheal tube placement is of paramount importance to prevent hypoxia and its catastrophic consequences. Despite certain limitations, capnography is considered the gold standard to evaluate the proper placement of an endotracheal tube. Ultrasound is a novel tool with some definitive advantages over capnography. It enables a real-time view and can be performed quickly; furthermore, it is independent of pulmonary blood flow and does not require lung ventilation. In this review, we aimed to evaluate the diagnostic accuracy of transtracheal ultrasound in detecting endotracheal intubation.

Source

We completed an extensive search of MEDLINE®, EMBASE™, The Cochrane Library, KoreaMed, LILACS, OpenGrey, and the World Health Organization International Clinical Trials Registry from their inception to September 4, 2014. The studies that met the inclusion criteria were pooled and a meta-analysis was conducted.

Principal findings

Eleven studies and 969 intubations were included in the final analysis. Eight studies and 713 intubations were performed in emergency situations and the others were carried out in elective situations. Transtracheal ultrasonography’s pooled sensitivity and specificity with 95% confidence intervals (CIs) were 0.98 (95% CI 0.97 to 0.99) and 0.98 (95% CI 0.95 to 0.99), respectively. In emergency scenarios, transtracheal ultrasonography showed an aggregate sensitivity and specificity of 0.98 (95% CI 0.97 to 0.99) and 0.94 (95% CI 0.86 to 0.98), respectively.

Conclusion

Transtracheal ultrasound is a useful tool to confirm endotracheal intubation with an acceptable degree of sensitivity and specificity. It can be used in emergency situations as a preliminary test before final confirmation by capnography.
Appendix
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Metadata
Title
Transtracheal ultrasound for verification of endotracheal tube placement: a systematic review and meta-analysis
Authors
Saurabh Kumar Das, MD
Nang Sujali Choupoo, MD
Rudrashish Haldar, MD
Amitabh Lahkar, MD
Publication date
01-04-2015
Publisher
Springer US
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 4/2015
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-014-0301-z

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