Assessment of the Endotracheal Tube Tip Position by Bedside Ultrasound in a Pediatric Intensive Care Unit: A Cross-sectional Study.

Content Provider	Europe PMC
Author	Subramani, Seenivasan Parameswaran, Narayanan Ananthkrishnan, Ramesh Abraham, Shilpa Chidambaram, Muthu Rameshkumar, Ramachandran Subramanian, Mahadevan
Copyright Year	2022
Abstract	IntroductionThe chest X-ray (CXR) is the standard of practice to assess the tip of the endotracheal tube (ETT) in ventilated children. In many hospitals, it takes hours to get a bedside CXR, and it has radiation exposure. The objective of this study was to find the utility of bedside ultrasound (USG), in assessing the ETT tip position in a Pediatric Intensive Care Unit (PICU).MethodsIt was a prospective study conducted in the PICU of a tertiary care center involving 135 children aged from 1 month to 60 months, requiring endotracheal intubation. In this study, the authors compared the position of the ETT tip by the CXR (gold standard) and USG. The CXR was taken in children to assess the correct position of the tip of ETT. The USG was used to measure the distance between the tip of ETT and the arch of the aorta, thrice in the same patient. The mean of the three USG readings was compared with the distance between the tip of the ETT and carina in CXR.ResultsThe reliability of three USG readings was tested by absolute agreement coefficient in intraclass correlation (ICC), 0.986 (95% CI: 0.981–0.989). The sensitivity and specificity of the USG in identifying the correct position of the ETT tip in children when compared to CXR were 98.10% (95% CI: 93.297–99.71%) and 50.0% (95% CI: 31.30–68.70%), respectively.ConclusionIn ventilated children <60 months of age, identifying the tip of ETTs by bedside the USG has good sensitivity (98.10%) but poor specificity (50.0%).How to cite this articleSubramani S, Parameswaran N, Ananthkrishnan R, Abraham S, Chidambaram M, Rameshkumar R, et al. Assessment of the Endotracheal Tube Tip Position by Bedside Ultrasound in a Pediatric Intensive Care Unit: A Cross-sectional Study. Indian J Crit Care Med 2022;26(11):1218–1224.
ISSN	09725229
Journal	Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine
Volume Number	26
PubMed Central reference number	PMC9983650
Issue Number	11
PubMed reference number	36873587
e-ISSN	1998359X
DOI	10.5005/jp-journals-10071-24355
Language	English
Publisher	Jaypee Brothers Medical Publishers
Publisher Date	2022-11-01
Access Restriction	Open
Rights License	© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd.
Subject Keyword	Bedside ultrasound Children Endotracheal tube tip position
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine