Use of ultrasonograph in the verification of urgent tracheal intubation in pediatrics: preliminary experience

Abstract

Introduction and objectives. Direct laringoscopy is the standard method to confirm proper endotracheal tube placement; capnography represents the second most recommended method. Nowadays, ultrasound is gaining interest as an alternative and complementary technique, which also allows the comprobation of respiratory movements. Unfortunately this use is still limited. This study aimed to show our experience with the use of ultrasound for this purpose, describing and illustrating the technique in a small series of patients.
Material and methods. Proper intubation in longitudinal and transverse plane, as well as the absence of selective bronchial intubation was verified by ultrasound. Subse-quently the obtained images were reviewed and analyzed by a second researcher to evaluate the correlation between them.
Clinical cases. Seven intubations in five patients were included, none of them were esophagical. The average time to verify was 63.5 (28-97.5) seconds. Correct tube position was considered by ultrasound lung sliding and diaphragmatic motility in 6 cases, in contrast with 5 cases by conventional radiography. In 27 of 28 recorded images there was an agreement between both researchers.