Emergency Identification of Endotracheal Tube Tip via Ultrasonography Used by Trained Nurse in the Neonatal Intensive Care Unit (NICU)

<b>Background:</b> Endotracheal tube (ETT) placement is crucial for neonates with respiratory failure. Ultrasonography (US) has emerged as a valuable tool to detect ETT positioning, competing with traditional methods. Nurses, being front-line caregivers, can perform basic ultrasound exam...

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Main Authors: Athanasia Voulgaridou, Savas Deftereos, Pelagia Chloropoulou, Konstantina Bekiaridou, Emmanouela Tsouvala, Rozita Meziridou, Soultana Foutzitzi, Christos Kaselas, Xenophon Sinopidis, Elpis Mantadakis, Katerina Kambouri
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/3/262
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author Athanasia Voulgaridou
Savas Deftereos
Pelagia Chloropoulou
Konstantina Bekiaridou
Emmanouela Tsouvala
Rozita Meziridou
Soultana Foutzitzi
Christos Kaselas
Xenophon Sinopidis
Elpis Mantadakis
Katerina Kambouri
author_facet Athanasia Voulgaridou
Savas Deftereos
Pelagia Chloropoulou
Konstantina Bekiaridou
Emmanouela Tsouvala
Rozita Meziridou
Soultana Foutzitzi
Christos Kaselas
Xenophon Sinopidis
Elpis Mantadakis
Katerina Kambouri
author_sort Athanasia Voulgaridou
collection DOAJ
description <b>Background:</b> Endotracheal tube (ETT) placement is crucial for neonates with respiratory failure. Ultrasonography (US) has emerged as a valuable tool to detect ETT positioning, competing with traditional methods. Nurses, being front-line caregivers, can perform basic ultrasound examinations. This study aimed to assess whether a nurse inexperienced in US could identify the correct ETT position in neonates after a brief ultrasound training. <b>Methods:</b> This study included intubated neonates hospitalized in a NICU with a postmenstrual age of under 45 weeks. A NICU nurse, following a short ultrasound training, measured the distance of the ETT tip to the right pulmonary artery and aortic arch. Chest X-rays (CXRs) confirmed the ETT position. The neonates’ ages, genders, weights, and examination times were recorded. <b>Results:</b> This study involved 67 neonates, including 40 (59.7%) males, with 39 (58.2%) weighing below 1500 g. The median time for correct ETT placement confirmation by CXR was 12.6 min, while US-assisted ETT recognition took 6 min initially and 5.1 min at the end of the training, which was a significant difference. No major differences were found in US distance based on the neonate’s weight and age. Gender marginally influenced US distance (β = −0.089, <i>p</i> = 0.056). <b>Conclusions:</b> The NICU nurse responded well to ultrasound training, showing results comparable with CXR. Further studies with more patients and additional studied factors are needed to fully assess US’s reliability in determining ETT positioning.
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spelling doaj-art-cf50f74516cb4fc6a576e68ab1c257062025-08-20T03:12:35ZengMDPI AGDiagnostics2075-44182025-01-0115326210.3390/diagnostics15030262Emergency Identification of Endotracheal Tube Tip via Ultrasonography Used by Trained Nurse in the Neonatal Intensive Care Unit (NICU)Athanasia Voulgaridou0Savas Deftereos1Pelagia Chloropoulou2Konstantina Bekiaridou3Emmanouela Tsouvala4Rozita Meziridou5Soultana Foutzitzi6Christos Kaselas7Xenophon Sinopidis8Elpis Mantadakis9Katerina Kambouri10Neonatal Intensive Care Unit, Alexandroupolis University General Hospital, 68100 Alexandroupolis, GreeceDepartment of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, GreeceDepartment of Anesthesiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, GreeceDepartment of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, GreeceNeonatal Intensive Care Unit, Alexandroupolis University General Hospital, 68100 Alexandroupolis, GreeceNeonatal Intensive Care Unit, Alexandroupolis University General Hospital, 68100 Alexandroupolis, GreeceDepartment of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, GreeceDepartment of Pediatric Surgery, Papageorgiou General Hospital, Aristotele University of Thessaloniki, 56403 Thessaloniki, GreeceDepartment of Pediatric Surgery, University General Hospital of Patras, 26504 Rio, GreeceDepartment of Pediatrics, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, GreeceDepartment of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece<b>Background:</b> Endotracheal tube (ETT) placement is crucial for neonates with respiratory failure. Ultrasonography (US) has emerged as a valuable tool to detect ETT positioning, competing with traditional methods. Nurses, being front-line caregivers, can perform basic ultrasound examinations. This study aimed to assess whether a nurse inexperienced in US could identify the correct ETT position in neonates after a brief ultrasound training. <b>Methods:</b> This study included intubated neonates hospitalized in a NICU with a postmenstrual age of under 45 weeks. A NICU nurse, following a short ultrasound training, measured the distance of the ETT tip to the right pulmonary artery and aortic arch. Chest X-rays (CXRs) confirmed the ETT position. The neonates’ ages, genders, weights, and examination times were recorded. <b>Results:</b> This study involved 67 neonates, including 40 (59.7%) males, with 39 (58.2%) weighing below 1500 g. The median time for correct ETT placement confirmation by CXR was 12.6 min, while US-assisted ETT recognition took 6 min initially and 5.1 min at the end of the training, which was a significant difference. No major differences were found in US distance based on the neonate’s weight and age. Gender marginally influenced US distance (β = −0.089, <i>p</i> = 0.056). <b>Conclusions:</b> The NICU nurse responded well to ultrasound training, showing results comparable with CXR. Further studies with more patients and additional studied factors are needed to fully assess US’s reliability in determining ETT positioning.https://www.mdpi.com/2075-4418/15/3/262lungneonatesNICUnursingpediatric radiologyultrasonography
spellingShingle Athanasia Voulgaridou
Savas Deftereos
Pelagia Chloropoulou
Konstantina Bekiaridou
Emmanouela Tsouvala
Rozita Meziridou
Soultana Foutzitzi
Christos Kaselas
Xenophon Sinopidis
Elpis Mantadakis
Katerina Kambouri
Emergency Identification of Endotracheal Tube Tip via Ultrasonography Used by Trained Nurse in the Neonatal Intensive Care Unit (NICU)
Diagnostics
lung
neonates
NICU
nursing
pediatric radiology
ultrasonography
title Emergency Identification of Endotracheal Tube Tip via Ultrasonography Used by Trained Nurse in the Neonatal Intensive Care Unit (NICU)
title_full Emergency Identification of Endotracheal Tube Tip via Ultrasonography Used by Trained Nurse in the Neonatal Intensive Care Unit (NICU)
title_fullStr Emergency Identification of Endotracheal Tube Tip via Ultrasonography Used by Trained Nurse in the Neonatal Intensive Care Unit (NICU)
title_full_unstemmed Emergency Identification of Endotracheal Tube Tip via Ultrasonography Used by Trained Nurse in the Neonatal Intensive Care Unit (NICU)
title_short Emergency Identification of Endotracheal Tube Tip via Ultrasonography Used by Trained Nurse in the Neonatal Intensive Care Unit (NICU)
title_sort emergency identification of endotracheal tube tip via ultrasonography used by trained nurse in the neonatal intensive care unit nicu
topic lung
neonates
NICU
nursing
pediatric radiology
ultrasonography
url https://www.mdpi.com/2075-4418/15/3/262
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