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Comparison of real-time ultrasonography with waveform capnography in verifying endotracheal tube location- An observational study

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Original Article

Author Details : Tofazzel Haque Sahana*, Tarapada Das, Madhusudan Tiwari, Sabyasachi Das, Sekhar Ranjan Basu

Volume : 11, Issue : 2, Year : 2024

Article Page : 188-194

https://doi.org/10.18231/j.ijca.2024.037

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Abstract

Background: Immediate post-intubation confirmation of endotracheal tube requires direct observational or secondary gadgets-dependent measures having variable sensitivity and specificity. In this study, dynamic real-time ultrasonography is used for the evaluation of endotracheal tube. The correlation between the gold standard test(Capnography) and the unconventional test(Ultrasonography) is also evaluated.
Materials and Methods: One hundred ASA PS 1, and ASA PS 2 patients were evaluated for endotracheal intubation using real-time ultrasonography. The desired endotracheal intubation was further confirmed by using time capnography. Victorious tracheal intubation was identified using some radiological signs, only one air-mucosa interface with a comet-tail artefact and enhanced posterior acoustic shadowing indicative of endotracheal intubation. Two air-mucosa interfaces with comet-tail artefacts with posterior shadowing were indicative of oesophageal intubation.
Results: The mean (SD) ages of the studied patients were 41.25±7.76 Yrs. A total of 87% of patients had endotracheal intubation and 13% had oesophageal intubation based on ultrasonography scan findings. Capnography finding was 91% endotracheal intubations, 9% were true oesophageal. The true positive and true negative rate, positive predictive value and negative predictive values of real-time ultrasonography were 95%, (95% confidence interval (CI) 88% to 98%) 100% (95% CI 62% to 100%), 100% (95% CI 94% to 100%), 69% (95% CI 38% to 89%) respectively. Kappa (k) value was 0.8.
Conclusion: Ultrasonography is a portable sensitive screening equipment for ETT position confirmation. There is a strong association between USG findings with time capnography results.
 

Keywords: Real- time USG, Main stream time capnography, ETT position.

How to cite : Sahana T H, Das T, Tiwari M, Das S, Basu S R, Comparison of real-time ultrasonography with waveform capnography in verifying endotracheal tube location- An observational study. Indian J Clin Anaesth 2024;11(2):188-194

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