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Ultrasonography for endotracheal tube position in infants and children

Pooja Jaeel1, Mansi Sheth1, Jimmy Nguyen2,3

  • 1Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

European Journal of Pediatrics
|January 17, 2017
PubMed

Insights

Ultrasonography (US) is effective for verifying endotracheal tube (ETT) placement in pediatric patients. This imaging technique appears well-tolerated and can complement other methods like radiography and capnography.

Area of Science:

  • Pediatric Emergency Medicine
  • Medical Imaging
  • Critical Care

Background:

  • Point-of-care ultrasonography (POCUS) use is increasing in pediatric specialties.
  • Ultrasonography is established for verifying endotracheal tube (ETT) position in adults.
  • Limited research exists on US for ETT verification in pediatric populations.

Purpose of the Study:

  • To review the literature on the use of ultrasonography for endotracheal tube positioning in infants and children.
  • To assess the efficacy and tolerability of US in pediatric ETT verification.

Main Methods:

  • Literature search conducted using Ovid and MEDLINE databases.
  • Search terms focused on ultrasonography, endotracheal intubation, and positioning in pediatric patients.
  • Analysis of studies reporting visualization rates and correlation with radiography.

Main Results:

  • Studies in neonates and infants utilized midsagittal suprasternal views, achieving >80% ETT tip visualization.
  • US interpretation of ETT position correlated with radiography in 73-100% of cases.
  • In older children, various views (suprasternal, substernal, mid-axillary) were used, showing US comparable to radiography and capnography.

Conclusions:

  • Ultrasonography for ETT verification is well-tolerated in infants and children.
  • US can augment ETT position determination when used with other modalities like radiography and capnography.
  • Further research is needed on technique optimization and training for pediatric ETT US.

Keywords:
Endotracheal intubationIntubationNeonatal-perinatal medicineNeonatologyPediatricPoint-of-careResuscitationUltrasonographyUltrasound

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