一项比较研究,以确认使用超声波和标准听觉方法在儿童的内管放置
Neha Sinha1, Nandita Kad2, Mayuri Golhar2
1Department of Cardiac Anaesthesia, Pandit Bhagwat Dayal Sharma PGIMS, Rohtak, India.
Asian journal of anesthesiology
|February 6, 2024
概括
超声指导的肺滑动是一种可靠的方法,用于确认儿童的内管 (ETT) 位置,提供比单独听觉更高的准确性. 这种技术对于预防儿科患者严重并发症至关重要.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 医疗成像医学成像
- 关键护理医学 关键护理医学
背景情况:
- 儿科患者有较高的风险内管 (ETT) 错位由于更短的气管,导致严重的并发症.
- 确认ETT安置的标准听力测试在准确性上有局限性.
- 超声波引导的肺滑动为验证ETT位置提供了一个潜在的替代方案.
研究的目的:
- 为了比较标准听觉和超声波引导的肺滑动的准确性和效率,以确认儿科患者的内管 (ETT) 位置.
- 为了评估诊断的准确性和确认所需的时间,使用这两种方法与波形图相比.
- 为了确定超声波引导的肺滑动作为儿科输管诊断工具的可靠性.
主要方法:
- 一项涉及75名儿科患者 (2-8岁,ASA I-II) 的研究,这些患者接受了内内管道输入管道的全身麻醉.
- 通过双边胸部听觉和超声检查肺滑动迹象来评估ETT位置.
- 研究结果与波形图进行了比较,以确定灵敏度,特异性,准确性和诊断时间.
主要成果:
- 超声波显示灵敏度为94.31%,特异性为72.33%,准确度为90.7%,相比于头像.
- 标准听觉显示了较低的准确性,82.8%的灵敏度,47.28%的特异性和74.67%的准确性.
- 波形光学是最快的 (10.29秒),其次是听觉 (12.96秒) 和超声学 (14.28秒) 进行确认.
结论:
- 仅仅标准的听觉测试就会产生很高的错误阴性结果,因此超声波或图确认是必不可少的.
- 超声波引导的肺滑动是一种简单,快速和可靠的方法,用于检测儿童的内管错位.
- 超声波和波形图都优于听觉,可以在儿科患者中准确确认ETT位置.
相关概念视频
Endotracheal Intubation I: Procedure
1.3K
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
1.3K
Physical Assessment of the Respiratory Tract IV: Auscultation
408
Auscultation is a crucial component of the physical assessment of the respiratory tract. It offers valuable insights into airflow through the bronchial tree and potential lung obstructions. This process involves careful listening to breath, voice, and adventitious sounds, which can reveal a wealth of information about a patient's respiratory health.
Breath Sounds
Breath sounds are categorized into vesicular, bronchovesicular, and bronchial.
Breath Sounds
Breath sounds are categorized into vesicular, bronchovesicular, and bronchial.
408
Assessment of apical pulse
947
Assessing the Apical Pulse
Assessing the apical pulse is a critical nursing procedure, particularly indicated for:
Assessing the apical pulse is a critical nursing procedure, particularly indicated for:
947
Endoscopic Studies II: Thoracocentesis
261
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
261
Endoscopic Studies I: Bronchoscopy and Thoracoscopy
199
Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
199
Respiratory System Abnormal Finding II: Palpation and Auscultation
466
In assessing respiratory abnormalities, palpation and auscultation are critical tools for detecting and interpreting various pathophysiological changes. These techniques provide insight into underlying disorders by evaluating tactile sensations and sounds produced by the respiratory system.
Palpation Findings
During a respiratory assessment, palpation can reveal several vital abnormalities:
Palpation Findings
During a respiratory assessment, palpation can reveal several vital abnormalities:
466


