应用床边超声(Us)确定儿科和新生儿气管插管(ETT)位置新兴工具

Y. Ethawi
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引用次数: 1

摘要

美国有一个很有前途的替代方法来快速确认ETT的放置。然而,很少有研究表明,相对于胸部x光或血管造影,该工具准确评估ETT位置的灵敏度约为91-100%。这种方法的总体准确率非常有趣,在一些研究中达到了89-98%。其中一些研究表明,这种方法的另一个优点是可以快速评估ETT的位置;使用美国曲线探头,最快可达17秒。可以理解的是,对于短颈患者和佩戴颈套的患者,ETT位置的确定有些困难。我相信在不久的将来使用这种方法是值得研究的。虽然这些研究的大多数对象是成人和儿童,但我不认为在新生儿中使用这种工具有什么限制,特别是如果在一些设施中插管和进行确证性XR之间的等待时间很长。根据各种小型观察性研究,床边US可用于1。直接观察气管内气管外排气管2。示肺滑动3。横隔膜的偏移
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Confirming Endotracheal Tube (ETT) Position in Pediatric and Neonatology Using a Bedside Ultrasound (Us); an Emerging Tool
US have a promising alternative mean for quick confirmation of the ETT placement. However, small and few studies have shown that the sensitivity of this tool to accurately assess the ETT placement relative to chest XR or capnography is approximately 91-100%. The overall accuracy of this method is very interesting as it reaches 89-98% in some studies. An additional advantage of this method as suggested by some of these studies is the rapid assessment of the ETT position; this can be as quick as 17 seconds using an US curvilinear probe. Understandably, the confirmation of the ETT position was somewhat challenging in short neck patients and in those wearing cervical collars. I believe that using this method is worth looking into in the near future. Although most of the subjects of these studies were adults and children, I don't see a limitation to use this tool in neonatology, especially if the waiting time between intubation and doing confirmatory XR in some facilities is long. Based upon various small observational studies, bedside US can be used to 1. Direct visualization of the ETT in the trachea 2. Showing lung sliding 3. Diaphragmatic Excursion
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