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Ultrasonographic evaluation of endotracheal tube position in newborns with CHD

Published online by Cambridge University Press:  15 December 2022

Başak Kaya Gürsoy Open the ORCID record for Başak Kaya Gürsoy [Opens in a new window] ,
Dilek Dilli Open the ORCID record for Dilek Dilli [Opens in a new window] ,
Yasin Sarıkaya ,
Hasan Akduman ,
Rumeysa Çitli ,
Utku Arman Örün Open the ORCID record for Utku Arman Örün [Opens in a new window] ,
Mehmet Taşar Open the ORCID record for Mehmet Taşar [Opens in a new window]  and
Ayşegül Zenciroğlu
Başak Kaya Gürsoy
Affiliation:
Department of Neonatology, University of Health Sciences of Türkiye, Ankara Dr Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Türkiye
Dilek Dilli*
Affiliation:
Department of Neonatology, University of Health Sciences of Türkiye, Ankara Dr Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Türkiye
Yasin Sarıkaya
Affiliation:
Department of Radiology, University of Health Sciences of Türkiye, Ankara Dr Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Türkiye
Hasan Akduman
Affiliation:
Department of Neonatology, University of Health Sciences of Türkiye, Ankara Dr Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Türkiye
Rumeysa Çitli
Affiliation:
Department of Neonatology, University of Health Sciences of Türkiye, Ankara Dr Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Türkiye
Utku Arman Örün
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences of Türkiye, Ankara Dr Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Türkiye
Mehmet Taşar
Affiliation:
Department of Pediatric Cardiovascular Surgery, University of Health Sciences of Türkiye, Ankara Dr Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Türkiye
Ayşegül Zenciroğlu
Affiliation:
Department of Neonatology, University of Health Sciences of Türkiye, Ankara Dr Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Türkiye
*
Author for correspondence: Prof. Dilek Dilli, Neonatology, University of Health Sciences of Türkiye, Ankara Dr Sami Ulus Maternity and Children Training and Research Hospital, Babür street, No: 44 (06080), Altındağ, Ankara, Turkey. E-mail: dilekdilli2@yahoo.com
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Abstract

Many studies have been conducted to determine the most reliable technique for evaluating the position of the endotracheal tube in patients receiving mechanical ventilation support. In this study, we aimed to determine the endotracheal tube position by ultrasonography in intubated patients with a diagnosis of critical CHD followed in the neonatal ICU.

Methods:

In this prospective observational clinical study, we performed point-of-care ultrasound for endotracheal tube localisation in 65 intubated newborns with critical CHD. After routine radiography, each patient underwent point-of-care ultrasound examination with a portable ultrasonography device for endotracheal tube end-carina measurement. Endotracheal tube end-carina measurements on chest radiographs were compared with ultrasound images.

Results:

The mean gestational age and birth weight were 37.8 ± 2.19 weeks and 2888 ± 595 g, respectively. Ultrasound images were obtained after an average of 2.08 ± 1.6 hours from the radiographs. The average ultrasound time allocated to each patient was 5 minutes. The mean endotracheal tube tip-to-carina distance on chest X-ray and ultrasound were optimally 1.33 ± 0.64 cm and 1.43 ± 0.67 cm, respectively. There was no significant difference between chest X-ray and ultrasound measurements in endotracheal tube end-carina distance values evaluated by the Bland–Altman method (mean difference 0.10 cm, p = 0.068). There was a linear correlation between the endotracheal tube tip-carina distance in ultrasound and radiography evaluation (r2 = 0.60, p < 0.001).

Conclusion:

It has been concluded that critical CHDs are frequently accompanied by vascular anomalies, and the endotracheal tube tip-carina distance measurement can be used by determining the carina section as a guide point in the ultrasonographic evaluation of the endotracheal tube location in this patient population.

Keywords

Neonateultrasoundendotracheal tube positioncritical CHD
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 10 , October 2023 , pp. 2049 - 2053
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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