Transtracheal ultrasonography versus endtidal capnography in rapid confirmation of endotracheal tube placement
Background: Prompt confirmation of proper endotracheal (ET) tube placement after intubation is imperative to averting life-threatening consequences. Waveform capnography, although the gold standard method, poses some limitations while transtracheal ultrasonography (USG) is a reliable real-time techn...
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Manipal College of Medical Sciences, Pokhara
2025-03-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://ajmsjournal.info/index.php/AJMS/article/view/4411 |
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| author | Shruthi Rioniz Nischala Dixit Preethi Rioniz Thomas T Vellapally Nayanthara Joachim Siddhanth Suresh |
| author_facet | Shruthi Rioniz Nischala Dixit Preethi Rioniz Thomas T Vellapally Nayanthara Joachim Siddhanth Suresh |
| author_sort | Shruthi Rioniz |
| collection | DOAJ |
| description | Background: Prompt confirmation of proper endotracheal (ET) tube placement after intubation is imperative to averting life-threatening consequences. Waveform capnography, although the gold standard method, poses some limitations while transtracheal ultrasonography (USG) is a reliable real-time technique that has shown much promise. Existing literature on the faster method has yielded conflicting results.
Aims and Objectives: This study aims to determine the mean time taken to confirm the correct placement of the ET tube using both transtracheal USG and end-tidal capnography. A comparative assessment of the faster method will supplement patient care by helping anesthesiologists avoid accidental esophageal/endobronchial intubation and the associated morbidity.
Materials and Methods: Consenting adult patients posted for elective surgeries under general anesthesia were recruited over a period of 18 months. The time taken for confirmation of correct tube placement by both transtracheal USG and capnographic end-tidal carbon dioxide tracing was recorded. A paired samples t-test was used to compare the means (±standard deviation).
Results: The study included 112 patients aged 40.1±12 years of whom 59 (52.6%) were females. The mean time taken to confirm tube placement by USG and capnography was 35.8±9.8 s and 67.4±13.7 s, respectively, with a mean time difference of 31.6±7.8 s which was found to be statistically significant (P<0.001).
Conclusion: Transtracheal USG is the faster method to confirm the proper placement of an ET tube during intubation when compared to waveform capnography. USG is also beneficial in detecting and avoiding accidental esophageal intubations. |
| format | Article |
| id | doaj-art-227ca539abe14bdeaddbe78d73019be8 |
| institution | OA Journals |
| issn | 2467-9100 2091-0576 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj-art-227ca539abe14bdeaddbe78d73019be82025-08-20T02:11:17ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-03-011632429https://doi.org/10.71152/ajms.v16i3.4411Transtracheal ultrasonography versus endtidal capnography in rapid confirmation of endotracheal tube placementShruthi Rioniz 0https://orcid.org/0009-0005-5956-8770Nischala Dixit 1https://orcid.org/0000-0001-6690-2400Preethi Rioniz 2https://orcid.org/0009-0009-0836-059XThomas T Vellapally 3https://orcid.org/0000-0001-7311-9860Nayanthara Joachim 4https://orcid.org/0000-0002-9530-4423Siddhanth Suresh 5https://orcid.org/0000-0002-7345-050XSenior Resident, Department of Anaesthesiology, St. John’s Medical College Hospital, Bengaluru, Karnataka, India Professor, Department of Anaesthesiology, St. John’s Medical College Hospital, Bengaluru, Karnataka, India Senior Resident, Department of Pharmacology, Chikkamagaluru Institute of Medical Sciences, Chikkamagaluru, Karnataka, India Assistant Professor, Department of Anaesthesiology, St. John’s Medical College Hospital, Bengaluru, Karnataka, India Assistant Professor, Department of Anaesthesiology, St. John’s Medical College Hospital, Bengaluru, Karnataka, India Junior Resident, Department of Radiodiagnosis, St. John’s Medical College Hospital, Bengaluru, Karnataka, India Background: Prompt confirmation of proper endotracheal (ET) tube placement after intubation is imperative to averting life-threatening consequences. Waveform capnography, although the gold standard method, poses some limitations while transtracheal ultrasonography (USG) is a reliable real-time technique that has shown much promise. Existing literature on the faster method has yielded conflicting results. Aims and Objectives: This study aims to determine the mean time taken to confirm the correct placement of the ET tube using both transtracheal USG and end-tidal capnography. A comparative assessment of the faster method will supplement patient care by helping anesthesiologists avoid accidental esophageal/endobronchial intubation and the associated morbidity. Materials and Methods: Consenting adult patients posted for elective surgeries under general anesthesia were recruited over a period of 18 months. The time taken for confirmation of correct tube placement by both transtracheal USG and capnographic end-tidal carbon dioxide tracing was recorded. A paired samples t-test was used to compare the means (±standard deviation). Results: The study included 112 patients aged 40.1±12 years of whom 59 (52.6%) were females. The mean time taken to confirm tube placement by USG and capnography was 35.8±9.8 s and 67.4±13.7 s, respectively, with a mean time difference of 31.6±7.8 s which was found to be statistically significant (P<0.001). Conclusion: Transtracheal USG is the faster method to confirm the proper placement of an ET tube during intubation when compared to waveform capnography. USG is also beneficial in detecting and avoiding accidental esophageal intubations.https://ajmsjournal.info/index.php/AJMS/article/view/4411general anesthesia; airway management; intubation; capnography; ultrasonography; endotracheal tube |
| spellingShingle | Shruthi Rioniz Nischala Dixit Preethi Rioniz Thomas T Vellapally Nayanthara Joachim Siddhanth Suresh Transtracheal ultrasonography versus endtidal capnography in rapid confirmation of endotracheal tube placement Asian Journal of Medical Sciences general anesthesia; airway management; intubation; capnography; ultrasonography; endotracheal tube |
| title | Transtracheal ultrasonography versus endtidal capnography in rapid confirmation of endotracheal tube placement |
| title_full | Transtracheal ultrasonography versus endtidal capnography in rapid confirmation of endotracheal tube placement |
| title_fullStr | Transtracheal ultrasonography versus endtidal capnography in rapid confirmation of endotracheal tube placement |
| title_full_unstemmed | Transtracheal ultrasonography versus endtidal capnography in rapid confirmation of endotracheal tube placement |
| title_short | Transtracheal ultrasonography versus endtidal capnography in rapid confirmation of endotracheal tube placement |
| title_sort | transtracheal ultrasonography versus endtidal capnography in rapid confirmation of endotracheal tube placement |
| topic | general anesthesia; airway management; intubation; capnography; ultrasonography; endotracheal tube |
| url | https://ajmsjournal.info/index.php/AJMS/article/view/4411 |
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