Pulmonary atelectasis in newborns with clinically treatable diseases who are on mechanical ventilation: clinical and radiological aspects

Abstract Objective: To analyze the radiological aspects of pulmonary atelectasis in newborns on mechanical ventilation and treated in an intensive care unit, associating the characteristics of atelectasis with the positioning of the head and endotracheal tube seen on the chest X-ray, as well as with the clinical variables. Materials and Methods: This was a retrospective cross-sectional study of 60 newborns treated between 1985 and 2015. Data were collected from medical records and radiology reports. To identify associations between variables, we used Fisher's exact test. The level of significance was set at p < 0.05. Results: The clinical characteristics associated with improper positioning of the endotracheal tube were prematurity and a birth weight of less than 1000 g. Among the newborns evaluated, the most common comorbidity was hyaline membrane disease. Atelectasis was seen most frequently in the right upper lobe, although cases of total atelectasis were more common in the left lung. Malpositioning of the head showed a trend toward an association with atelectasis in the left upper lobe. Conclusion: Pulmonary atelectasis is a common complication in newborns on mechanical ventilation. Radiological evaluation of the endotracheal tube placement provides relevant information for the early correction of this condition.

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DETERMINANTS OF ORAL ENDOTRACHEAL TUBE PLACEMENT: A CROSS SECTIONAL STUDY

10.36106/ijar/5902320 ◽

2021 ◽

pp. 66-68

Author(s):

Pankaj Kumar ◽

Sudha Singh ◽

Aditya Prakash

Keyword(s):

Endotracheal Tube ◽

Pearson Correlation ◽

Orotracheal Intubation ◽

Cross Sectional Study ◽

Tube Placement ◽

Vocal Cords ◽

Cross Sectional ◽

Endotracheal Tube Placement ◽

The Mean ◽

The Right

Introduction: Finding the best depth of endotracheal tube (ET) placement has been a challenge because of the complications caused due to its malposition. Aims: To nd the best depth of placement of oral ET in Indian adult patients. Methods And Design: This study was conducted in 125 ASA I and II patients requiring general anaesthesia and orotracheal intubation. Methods: After placing the ET with the designated black mark at vocal cords, various airway distances were measured from the right angle of mouth using a bre optic bronchoscope. Statistical Analysis: Mean (SD) and median (range) of various parameters and Pearson correlation coefcient was calculated. Results: The mean lip-carina distance, i.e., total airway length was 23.52±1.72 cm and 22.11±1.26 cm in males and females, respectively. With black mark of ET between vocal cords, the mean ET tip-carina distance of 4.19±1.60 cm in males and 2.78±1.52 cm females was found to be less than the recommended safe distance. Conclusions: Height has the best correlation to lip to carina distance. Fixing the tube at recommended distances in both male and female will lead to carinal stimulation or endobronchial placement in many Indian patients. The formula “(Height in cm/7) -2.5.” gives us an idea about the approximate depth of ET placement.

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Pilot Study to Evaluate the Accuracy of Ultrasonography in Confirming Endotracheal Tube Placement

Ultrasound Quarterly ◽

10.1097/01.ruq.0000263829.79992.e5 ◽

2007 ◽

Vol 23 (1) ◽

pp. 43

Author(s):

&NA;

Keyword(s):

Pilot Study ◽

Endotracheal Tube ◽

Tube Placement ◽

Endotracheal Tube Placement

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Assessment of gas flow waves for endotracheal tube placement in an ovine model of neonatal resuscitation

Resuscitation ◽

10.1016/j.resuscitation.2010.02.018 ◽

2010 ◽

Vol 81 (6) ◽

pp. 737-741 ◽

Cited By ~ 13

Author(s):

G.M. Schmölzer ◽

S.B. Hooper ◽

K.J. Crossley ◽

B.J. Allison ◽

C.J. Morley ◽

...

Keyword(s):

Endotracheal Tube ◽

Gas Flow ◽

Neonatal Resuscitation ◽

Tube Placement ◽

Ovine Model ◽

Endotracheal Tube Placement

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THE SENSITIVITY, SPECIFICITY AND ACCURACY OF STATIC METHOD OF ULTRASONOGRAPHY TO CONFIRM ENDOTRACHEAL INTUBATION IN EMERGENCY DEPARTMENT.

10.36106/ijsr/6729269 ◽

2021 ◽

pp. 8-13

Author(s):

Pankaj Kumar Singh ◽

Budhaditya Sanyal ◽

Mohit Bhatnagar ◽

Mandeep Joshi ◽

Shreya Verma

Keyword(s):

Diagnostic Accuracy ◽

Endotracheal Tube ◽

Predictive Value ◽

Static Method ◽

Tube Placement ◽

Short Course ◽

Endotracheal Tube Placement ◽

Linear Probe ◽

Post Intubation ◽

Sensitivity Specificity

Aims and objectives: This study aims to assess the diagnostic accuracy and timeliness of ultrasonography by static method only for identication of Endotracheal tube (ET Tube) placement in the trachea in emergency settings vs existing clinical methods. Material and Methods: This prospective study was carried out in the emergency room from October 2018 till the end of March 2019. The ultrasonography was performed in 120 emergency patients only after the intubation had been completed ie, static phase. A linear probe was used over the neck to identify the predened signs of ET intubation. Residents who perform ultrasound examination ll a form after assessment of each patient. Results: It was found that Tracheal Intubation-USG Sensitivity was 99.1, Specicity was 91.7, Positive Predictive Value: 99.1, Negative Predictive Value was 91.7 and Accuracy was 98.3%. Ultrasonography can be used as an adjunct tool to verify the ETTposition by Emergency Physicians which can be performed easily after a brieng or short-course training.Conclusion:This study demonstrates that US imaging has a high diagnostic accuracy to immediately conrm proper ETT placement post-intubation in an emergency setup. Therefore, it seems that ultrasonography using a static technique only is a proper screening tool in determining endotracheal tube placement.

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