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Updated: Mar 24, 2026
Image Acquisition using Portable Sonography for Emergency Airway Management
Published on: September 28, 2022
Diagnostic Accuracy of Point-of-care Ultrasonography for Confirming Endotracheal Tube Placement in Adults: An Updated
Mohammed Alsabri1, Ahmed B Elsnhory2, Mohammed T Hasan3
1Department of Emergency, Althawara Modern General Hospital, Sanaa, Yemen; Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, United States of America.
Background:
Point-of-care ultrasonography (POCUS) is increasingly used to confirm endotracheal tube (ETT) placement; however, its overall diagnostic accuracy and speed compared with standard methods in adult emergency and critical care settings remain uncertain.
Methods:
We conducted a systematic review and meta-analysis of observational studies through May 2025 that evaluated POCUS for confirming ETT placement in adults (≥18 years) in emergency departments (EDs) and intensive care units (ICUs).
Results:
Thirty studies met the inclusion criteria. Point-of-care ultrasonography achieved a pooled sensitivity of 0.91 and a specificity of 0.98. The area under the curve (AUC) was 0.96 [95% confidence interval (CI): 0.88-1.00]. The mean time-to-confirmation was 19.62 seconds for POCUS vs 22.46 seconds for standard methods; however, this finding should be interpreted with caution due to extreme heterogeneity (I² > 99%).
Conclusion:
Point-of-care ultrasonography is a highly accurate, rapid, and reliable method for confirming ETT placement in adult ED and ICU settings. It demonstrates diagnostic performance comparable to previously reported capnography performance and provides unique advantages as an adjunctive tool, especially in scenarios where capnography may be unreliable.
How To Cite This Article:
Alsabri M, Elsnhory AB, Hasan MT, McClean CH, Abouelmagd K, Abady E, et al. Diagnostic Accuracy of Point-of-care Ultrasonography for Confirming Endotracheal Tube Placement in Adults: An Updated Systematic Review and Meta-analysis. Indian J Crit Care Med 2026;30(2):155-164.
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