Real time ultrasound guided endotracheal intubation should strive for identification of esophageal intubation

Resuscitation ◽  
2014 ◽  
Vol 85 (1) ◽  
pp. e9
Author(s):  
Jacob Miss ◽  
Arun Nagdev ◽  
Jahan Fahimi
Keyword(s):  
Real Time ◽  
Endotracheal Intubation ◽  
Esophageal Intubation ◽  
Ultrasound Guided

scholarly journals Application of bedside real-time tracheal ultrasonography for confirmation of emergency endotracheal intubation in patients in the intensive care unit

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051989477 ◽  
Author(s):  
Weiting Chen ◽  
Junbo Chen ◽  
Hehao Wang ◽  
Yingzi Chen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Real Time ◽  
Endotracheal Intubation ◽  
Fiberoptic Bronchoscopy ◽  
Esophageal Intubation ◽  
Predictive Values ◽  
Kappa Value ◽  
Life Threatening ◽  
Sensitivity Specificity

Objective Critically ill patients often require emergency endotracheal intubation and mechanical ventilation. When esophageal intubation is not confirmed early, treatment may be delayed, even for life-threatening conditions. We examined the accuracy of bedside real-time airway ultrasonography in confirming the endotracheal tube (ETT) position during emergency endotracheal intubation in patients in the intensive care unit (ICU). Methods This single-center prospective observational study included 118 patients who underwent urgent endotracheal intubation in the ICU of Taizhou Hospital of Integrated Traditional Chinese and Western Medicine. Tracheal ultrasonography was used to confirm the ETT position during endotracheal intubation, after which fiberoptic bronchoscopy was performed. The accuracy of bedside real-time tracheal ultrasonography in determining the ETT position was examined. Results Twelve (10.2%) patients underwent endotracheal intubation. The kappa value was 0.844, indicating perfect consistency between tracheal ultrasonography and fiberoptic bronchoscopy in identifying esophageal intubation. The sensitivity, specificity, and positive and negative predictive values of tracheal ultrasonography in determining the ETT position were 75.0%, 100%, 100%, and 97.2%, respectively. Conclusions Bedside real-time tracheal ultrasonography accurately assesses the ETT position in the ICU and can identify the ETT position during intubation. These findings have important clinical applications and are of great significance for treatment of ICU patients.

Study on Clinical Application of Different Ultrasound-Guided Planar Techniques in Minimally Invasive Percutaneous Nephrolithotomy

2021 ◽  
pp. 155335062199779
Author(s):  
Difu Fan ◽  
Leming Song ◽  
Monong Li ◽  
Chunxiang Luo ◽  
Xiaohui Liao ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Real Time ◽  
Clinical Application ◽  
Short Axis ◽  
Ultrasound Guided ◽  
Out Of Plane ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Plane Group ◽  
Plane Technique ◽  
Guided Puncture

Objective. The objective is to explore the clinical application value of ultrasound long- and short-axis planar technology in real-time guided puncture in minimally invasive percutaneous nephrology. Methods. The clinical data of 80 patients undergoing real-time ultrasound-guided minimally invasive percutaneous nephrolithotomy from September 2018 to October 2019 were analyzed. The patients were randomly divided into 2 groups with different ultrasound-guided puncture techniques, long-axis in-plane technique and short-axis out-of-plane technique. Results. Minimally invasive percutaneous nephrolithotomies under real-time ultrasound guidance were successfully completed in both groups of patients. The success rate of the first puncture in the short-axis out-of-plane group was significantly higher than that in the long-axis in-plane group, and the differences were statistically significant ( P <.05); the total puncture time in the short-axis out-of-plane group was significantly less than the long-axis in-plane group, and the differences were statistical significance ( P <.05); there was no significant difference in the single-stage stone removal rate, total percutaneous renal channels, total hospital stay, and rate of complications by the Clavien classification between the 2 groups ( P > .05). Conclusion. Ultrasound long-axis and short-axis planar technologies can achieve good clinical application results in real-time guided puncture to establish percutaneous renal channels during minimally invasive percutaneous nephrolithotomy. Compared with the long-axis in-plane technique, the short-axis out-of-plane technique can shorten the puncture time and improve the success rate of the first puncture.

scholarly journals A Study of Malposition of Central Venous Catheter – A Comparative Study between Ultrasound Guided and Anatomical Landmark Technique

2018 ◽  
Vol 2 (3) ◽  
pp. 277-281
Author(s):  
Lalit Kumar Rajbanshi ◽  
Sambhu Bahadur Karki ◽  
Batsalya Arjyal
Keyword(s):  
Real Time ◽  
Internal Jugular Vein ◽  
Subclavian Vein ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Anatomical Landmark ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Catheter Tip ◽  
Landmark Technique

Introduction: Central venous catheterization is a routine procedure for long-term infusion therapy and central venous pressure measurement. Sometimes, the catheter tip may be unintentionally placed at the position other than the junction of superior vena cava and right atrium. This is called malposition and can lead to erroneous pressure measurement, increase risk of thrombosis, venous obstruction or other life threatening complications like pneumothorax, cardiac temponade.Objectives: This study aimed to observe the incidence of the malposition and compare the same between ultrasound guided catheterization and blind anatomical landmark technique.Methodology: This study was a prospective comparative study conducted at the intensive care unit of Birat Medical College and Teaching Hospital for two-year duration. All the catheterizations were done either with the use of real time ultrasound or blind anatomical landmark technique. The total numbers of central venous catheterization, the total incidences of malposition were observed. Finally the incidences were compared between real time ultrasound guided technique and blind anatomical landmark technique.Results: In two-year duration of the study, a total of 422 central venous cannulations were successfully done. The real time ultrasound was used for 280 cannulations while blind anatomical landmark technique was used for 162 patients. The study observed various malposition in 36 cases (8.5%). The most common malposition was observed for subclavian vein to ipsilateral internal jugular vein (33.3%) followed by subclavian to subclavian vein (27.8%) and internal jugular to ipsilateral subclavian vein (16.7%). In four patients the catheter had a reverse course in the internal jugular vein while the tip was placed in pleural cavity in three cannulations. There was coiling of the catheter inside left subclavian vein in one patient. The malposition was significantly reduced with the use of the real time ultrasound (P< 0.001). However there is no significant difference in the incidence of the various malposition between ultrasound guidance technique and blind anatomical landmark technique when compared individually.Conclusion: The malposition of the central venous catheter tip was common complication with the overall incidence of 8.5%. The most common malposition was subclavian vein to internal jugular vein. The use of real time ultrasound during the catheterization procedure can significantly reduced the risk of malposition.Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 277-281

scholarly journals Ultrasonography: The Third Eye of Anaesthesiologist

2021 ◽  
pp. 235-238
Author(s):  
Kirti Gujarkar Mahatme ◽  
Pratibha Deshmukh ◽  
Parag Sable ◽  
Vivek Chakole
Keyword(s):  
Chronic Pain ◽  
Critical Care ◽  
Pain Management ◽  
Difficult Airway ◽  
Real Time ◽  
Endotracheal Intubation ◽  
Regional Anesthesia ◽  
Chronic Pain Management ◽  
The Third ◽  
Safe Anesthesia

Anesthesiology is an evolving branch. Most of the procedures done by anesthesiologists, are blind except for endotracheal intubation. Ultrasonography (USG) helps anesthesiologists to see the actual anatomy in real time and thus helps them to give safe anesthesia minimizing the complications in every aspect of the field like difficult airway, vascular access, regional anesthesia, chronic pain management and critical care.

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