Format

Send to

Choose Destination
Br J Anaesth. 2019 Apr 12. pii: S0007-0912(19)30223-5. doi: 10.1016/j.bja.2019.03.020. [Epub ahead of print]

Ultrasound-guided lung sliding sign to confirm optimal depth of tracheal tube insertion in young children.

Author information

1
Department of Anaesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Seoul, South Korea.
2
Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea.
3
Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: jiseon78.jeong@samsung.com.

Abstract

BACKGROUND:

The tip of the tracheal tube should lie at the mid-tracheal level after tracheal intubation in paediatric patients. Auscultation does not guarantee optimal positioning of the tracheal tube. We compared auscultation and the ultrasound-guided lung sliding sign to confirm optimal positioning of the tracheal tube in paediatric patients.

METHODS:

We studied 74 paediatric patients aged 0-24 months of ASA physical status 1-3 who were scheduled for elective surgery under general anaesthesia. All were randomly assigned to one of two groups: depth of tracheal tube confirmed by auscultation (Group A) or using the ultrasound-guided lung sliding sign (Group S).

RESULTS:

Optimal positioning of the tracheal tube was observed in 32 of 37 (87%) subjects in Group S and 24 of 37 (65%) subjects in Group A (difference in proportion, 22%; 95% confidence interval, 2-39%; P=0.030). Optimal depth correlated with patient height (adjusted coefficient=0.888, P<0.001).

CONCLUSIONS:

In paediatric patients younger than 24 months, use of the ultrasound-guided lung sliding sign was more accurate than auscultation for optimal positioning of the tracheal tube.

CLINICAL TRIAL REGISTRATION:

KCT 0003015.

KEYWORDS:

anaesthesia; auscultation; intubation; paediatrics; tracheal tube; ultrasonography

PMID:
30987765
DOI:
10.1016/j.bja.2019.03.020

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center