Critical Care: Late-Breaking Abstracts: Clinical Pulmonary and Critical Care Medicine |

Endotracheal Tube Position Confirmation by the Bedside Ultrasound in Respiratory Intensive Care Unit Patients FREE TO VIEW

Wei Lei, PhD; Fenglin Dong, MD; Jiajia Wang, MD; Yehan Zhu, PhD; Jian'an Huang, PhD
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Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A175. doi:10.1016/j.chest.2016.02.181
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SESSION TITLE: Late-Breaking Abstracts: Clinical Pulmonary and Critical Care Medicine

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, April 17, 2016 at 01:00 PM - 02:00 PM

PURPOSE: The application of ultrasound in the intubation of endotracheal tube (ETT) was reported recently, but these studies mainly focused on whether the ETT was inserted in the airway rather than in the esophagus. For respiratoryintensive care unit (RICU) patients, the ETT should not only be placed in the trachea, but also be located in a rational distance (2-5cm) from carina. One of the most usefulconfirmation methods isfiber bronchoscope, but the technique is expensive and invasive. Howeverthe technique of ultrasound is inexpensive and non-invasive. We hypothesize that bedside ultrasound would become a new powerful tool in confirmation the location of the ETT.

METHODS: We conducted a perspective study. From June 2014 to December 2015, 59 patients with ETT intubation were enrolled. After ETT insertion, the experienced ultrasound doctors used the bedside color Doppler ultrasonic diagnostic apparatus to measure the distance from the tip of ETT to the carina in the supraclavicular fossa. The results were recorded if the distance was 2-5 cm. Then the respiratory physicians who could skillfully operate the bronchoscope verified the position of ETT. The results were compared with those of ultrasound doctors’ measurement. Thus we could determine whether ultrasound could be used as an efficient tool in ETT conformation.

RESULTS: The ultrasound accurately measured the distance from the tip of ETT to the carina. Among 59 patients, the distance from the tip of ETT to the carina of 47 patients was within 2-5 cm. The distance of 4 cases was more than 5cm, 2 cases were less than 2cm, and 6 cases were failed to measure. The results of the ultrasound had a good consistency with the results of bronchoscope.

CONCLUSIONS: In summary, ultrasound is a sensitive diagnostic tool forconformation the tip position of ETT in adult patients. We suggest that ultrasound isa real-time, non-invasive, convenient, and radiation free diagnostic and monitoring tool in airway management of RICU patients.

CLINICAL IMPLICATIONS: The ultrasound can directly confirm the location of the ETT, and avoid the complications of malpositioned of ETT to the utmost extent.

DISCLOSURE: The following authors have nothing to disclose: Wei Lei, Fenglin Dong, Jiajia Wang, Yehan Zhu, Jian'an Huang

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