Diagnostic Accuracy Of Ultrasound For Confirmation Of Endotracheal Tube Placement Taking Capnography As A Gold Standard

Abstract

Introduction: Accurate placement of an endotracheal tube (ETT) is critical for patient safety during medical procedures. The research explores the potential of ultrasound technology to provide a reliable alternative for ETT confirmation, offering insights into its diagnostic performance and the implications for enhancing patient care in surgical settings.

Aims & Objectives: To determine the diagnostic accuracy of ultrasound for the confirmation of endotracheal tube keeping Capnography as a Gold standard.

Place and Duration of Study: It is a Cross Sectional study and the study was carried out in Operation Theater Shaikh Zayed Hospital Lahore, within 6 months after approval of synopsis i.e. from 5th May, 2020 till 4th November, 2021.

Material & Methods:Total 219 patients who fulfilled the inclusion criteria were enrolled. After standardization of anesthetic measures all patients were intubated by direct laryngoscopy. ETT placement was assessed by capnometry and by ultrasonography. Endotracheal tube placement was labeled (as per operational definition) on both the techniques.The analysis of the data was conducted using SPSS version 21.0, a p-value of ?0.05 was considered significant.

Results: The mean age, BMI, neck circumference and thyromental distance of the patients was 39±8.15 years, 27±3.42 Kg/m 2, 29.5±4.63cm and 6.9±0.50cm. There were 58% males and 42% females in the study. Ultrasonography exhibited sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rates of 98.5%, 90.6%, 98.9%, 86.1%, and 97.7%, respectively, in its ability to detect the accurate placement of endotracheal tubes (ETT).

Conclusion: The sensitivity, specificity, diagnostic accuracy and promptness of recognition for confirmation of tracheal placement of ETT is higher withultrasonography compared to the gold standardcapnography in patients undergoing elective surgery under general anesthesia.