Ultrasound Evaluation of Endotracheal Tube Depth
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | Any - 85 |
| Updated: | 4/2/2016 |
| Start Date: | July 2012 |
| End Date: | June 2016 |
| Contact: | Kai Schoenhage, MD |
| Email: | kschoenhage@anesth.arizona.edu |
| Phone: | (520) 626-7221 |
Ultrasound Evaluation of Endotracheal Tube Depth for Proper Tube Placement in Different Patient Groups
Correct positioning of the endotracheal tube (ETT) is crucial to ensure safe ventilation. To
date, no test that can verify this right after intubation at the bedside exists. Indirect
tests have false negative and positive results leading to complications or at least
difficulties in performing effective ventilation of patients.
Bedside ultrasound could fill this need. Although bedside ultrasound may not be possible or
useful in routine intubations, it may prove useful in difficult or questionable cases, where
current clinical exams/techniques may not offer a reliable indication of endotracheal tube
depth.
date, no test that can verify this right after intubation at the bedside exists. Indirect
tests have false negative and positive results leading to complications or at least
difficulties in performing effective ventilation of patients.
Bedside ultrasound could fill this need. Although bedside ultrasound may not be possible or
useful in routine intubations, it may prove useful in difficult or questionable cases, where
current clinical exams/techniques may not offer a reliable indication of endotracheal tube
depth.
Ultrasound is able to visualize some parts of the trachea and the ETT therein and although
the actual structures of interest (ETT tip and carina) are difficult or impossible to
visualize reliably (due to their air contents reflecting ultrasound beams) one can use
surrogates:
The cuff of the ETT can be visualized as it is in- or deflated or it can be filled with an
air-fluid(saline) mixture to delineate it inside the trachea.
For the same reason (air reflecting ultrasound beams) the carina is difficult to visualize
and one can use the aortic arch which is positioned just anterior to it instead.
This study apart from determining feasibility of the method may produce enough data from
ultrasound exams to develop/derive a more pre-cise algorithm than available today aiding in
positioning the endotracheal tube in regards to anatomic-al landmarks (teeth, gums, lips)
even without the use of ultrasound.
the actual structures of interest (ETT tip and carina) are difficult or impossible to
visualize reliably (due to their air contents reflecting ultrasound beams) one can use
surrogates:
The cuff of the ETT can be visualized as it is in- or deflated or it can be filled with an
air-fluid(saline) mixture to delineate it inside the trachea.
For the same reason (air reflecting ultrasound beams) the carina is difficult to visualize
and one can use the aortic arch which is positioned just anterior to it instead.
This study apart from determining feasibility of the method may produce enough data from
ultrasound exams to develop/derive a more pre-cise algorithm than available today aiding in
positioning the endotracheal tube in regards to anatomic-al landmarks (teeth, gums, lips)
even without the use of ultrasound.
Inclusion Criteria:
- requiring anesthesia with an endotracheal tube placed for surgical or procedural
purposes
- elective or stable and awake for urgent or emergent surgeries
Exclusion Criteria:
- known tracheal deformities
- thoracic aortic aneurysm
- neck/chest tissue thickness making U/S scanning difficult
- severe trauma, head injuries or any procedures that require immediate surgery
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