Diagnostic Accuracy of Suprasternal Versus Subxiphoid Ultrasonography for Endotracheal Intubation

AuthorSeyed Mohammad Mousavien
AuthorMaryam Sayyari Doughabadien
AuthorSeyed Ali Alamdaranen
AuthorSayyed Majid Sadrzadehen
AuthorHosein Zakerien
AuthorElnaz VafadarMoradien
OrcidSeyed Mohammad Mousavi [0000-0001-5608-4045]en
OrcidMaryam Sayyari Doughabadi [0000-0001-8946-3391]en
OrcidSeyed Ali Alamdaran [0000-0002-5966-2856]en
OrcidSayyed Majid Sadrzadeh [0000-0002-7261-025X]en
OrcidHosein Zakeri [0000-0001-7965-9657]en
OrcidElnaz VafadarMoradi [0000-0001-5164-4082]en
Issued Date2022-02-28en
AbstractBackground: Airway management is an important skill for emergency physicians, and confirmation of correct endotracheal tube (ETT) placement is a crucial component of airway management. Objectives: Due to the occurrence of incorrect ETT positioning in emergency departments, the present study aimed to compare the diagnostic sensitivity of ultrasound using suprasternal and subxiphoid methods for confirming the correct placement of ETT compared to capnography. Methods: This cross-sectional study was conducted by examining patients requiring intubation. Ultrasound was performed by two independent emergency medical assistants using two suprasternal and subxiphoid methods to confirm correct ETT placement; the results were then interpreted. To observe the tube passage through the vocal cords, capnography and lung auscultation were applied as the gold standards, and the results of two ultrasound methods were compared. Results: A total of 66 patients, who were intubated in the emergency department, participated in this study. The positive and negative predictive values, sensitivity, and specificity of supernatural ultrasound were 96.72%, 80%, 98.33%, and 66.67%, respectively. Also, positive and negative predictive values, sensitivity, and specificity of subxiphoid ultrasound were 97.95%, 29.41%, 80%, and 83.33%, respectively. The diagnostic odds ratios of suprasternal and subxiphoid ultrasounds were 1.026 and 1.024 compared to capnography, respectively. Conclusions: Ultrasonography using the suprasternal method was feasible. Considering the high sensitivity and specificity of this method in confirming correct ETT placement, it produced reliable results. Overall, this modality can be used as one of the main methods to verify correct ETT placement in emergency departments.en
DOIhttps://doi.org/10.5812/aapm.118592en
KeywordUltrasounden
KeywordCapnographyen
KeywordEndotracheal Tubeen
KeywordEmergency Departmenten
PublisherBrieflandsen
TitleDiagnostic Accuracy of Suprasternal Versus Subxiphoid Ultrasonography for Endotracheal Intubationen
TypeResearch Articleen

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