Diagnostic Accuracy of Lung Ultrasound in Determining the Position of the Endotracheal Tube in Mechanically Ventilated Children

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Abstract

Introduction: Due to their short and narrow airways, endotracheal intubation in children is difficult and demands a high degree of precision. Chest X-rays (CXR) are the current gold standard for endotracheal tube (ETT) verification. Objective: The aim of the current study was to evaluate the role of lung ultrasonography in confirming ETT installation in children receiving mechanical ventilation. Patients and methods: A cross-sectional study was carried out at pediatric intensive care unit (PICU), Faculty of Medicine, Zagazig University Children Hospitals. A total of 30 patients, aged between 28 days and 16 years were enrolled in the study. History taking and general clinical examination were performed on all patients. The ETT was inserted and the position is adjusted by the guide of ultrasonography (Alpinion E Cube i7). Thereafter, all patients were subjected to CXR. Results: Incidence of correct ETT position with CXR was 53.3% compared to 86.7% with ultrasound (P=0.002). Agreement between ETT position detected by CXR and ETT position detected by ultrasound had a fair level. Only 17 (56.7%) children were survived after endotracheal intubation and 13 (43.3%) died among the 30 studied children. Percent of children’s death among children of once intubation was 10%, while percent of children’s death among repeated intubation was 33.3%. Conclusion: Lung ultrasonography can be used as a fast, safe and effective tool for confirming the correct placement of ETT in mechanically ventilated children, especially in conditions where CXR and capnography are not reliable or inaccessible.
 

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The Egyptian Journal of Hospital Medicine
Volume 91, Issue 1
April 2023
Pages 4409-4413

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