The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Dan Lou Isbye - One of the best experts on this subject based on the ideXlab platform.
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temporal comparison of ultrasound vs auscultation and Capnography in verification of endotracheal tube placement
Acta Anaesthesiologica Scandinavica, 2011Co-Authors: P Pfeiffer, S S Rudolph, Jens Borglum, Dan Lou IsbyeAbstract:Background This study compared the time consumption of bilateral lung ultrasound with auscultation and Capnography for verifying endotracheal intubation. Methods A prospective, paired, and investigator-blinded study carried out in the operating theatre. Twenty-five adult patients requiring endotracheal intubation were included. During intubation, transtracheal ultrasound was performed to visualize passage of the endotracheal tube. During bag ventilation, bilateral lung ultrasound was performed for the detection of lung sliding as a sign of ventilation simultaneous with Capnography and auscultation of the epigastrium and chest. Primary outcome measure was time difference to confirmed endotracheal intubation between ultrasound and auscultation alone. Secondary outcome measure was time difference between ultrasound and auscultation combined with Capnography. Results Both methods verified endotracheal tube placement in all patients. In 68% of patients, endotracheal tube placement was visualized by real-time transtracheal ultrasound. Comparing ultrasound with the combination of auscultation and Capnography, there was a significant difference between the two methods. Median time for ultrasound was 40 s [interquartile range (IQR) 35–48 s] vs. 48 s (IQR 45–53 s), P < 0.0001. Mean difference was −7.1 s in favour of ultrasound [95% confidence interval (CI) −9.4–−4.8 s]. No significant difference was found between ultrasound compared with auscultation alone. Median time for auscultation alone was 42 s (IQR 37–47 s), P = 0.6, with a mean difference of −0.88 s in favour of ultrasound (95% CI −4.2–2.5 s). Conclusions Verification of endotracheal tube placement with ultrasound is as fast as auscultation alone and faster than the standard method of auscultation and Capnography.
Amitabh Lahkar - One of the best experts on this subject based on the ideXlab platform.
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transtracheal ultrasound for verification of endotracheal tube placement a systematic review and meta analysis
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2015Co-Authors: Saurabh Kumar Das, Nang Sujali Choupoo, Rudrashish Haldar, Amitabh LahkarAbstract:Purpose Early confirmation of endotracheal tube placement is of paramount importance to prevent hypoxia and its catastrophic consequences. Despite certain limitations, Capnography is considered the gold standard to evaluate the proper placement of an endotracheal tube. Ultrasound is a novel tool with some definitive advantages over Capnography. It enables a real-time view and can be performed quickly; furthermore, it is independent of pulmonary blood flow and does not require lung ventilation. In this review, we aimed to evaluate the diagnostic accuracy of transtracheal ultrasound in detecting endotracheal intubation.
P Pfeiffer - One of the best experts on this subject based on the ideXlab platform.
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temporal comparison of ultrasound vs auscultation and Capnography in verification of endotracheal tube placement
Acta Anaesthesiologica Scandinavica, 2011Co-Authors: P Pfeiffer, S S Rudolph, Jens Borglum, Dan Lou IsbyeAbstract:Background This study compared the time consumption of bilateral lung ultrasound with auscultation and Capnography for verifying endotracheal intubation. Methods A prospective, paired, and investigator-blinded study carried out in the operating theatre. Twenty-five adult patients requiring endotracheal intubation were included. During intubation, transtracheal ultrasound was performed to visualize passage of the endotracheal tube. During bag ventilation, bilateral lung ultrasound was performed for the detection of lung sliding as a sign of ventilation simultaneous with Capnography and auscultation of the epigastrium and chest. Primary outcome measure was time difference to confirmed endotracheal intubation between ultrasound and auscultation alone. Secondary outcome measure was time difference between ultrasound and auscultation combined with Capnography. Results Both methods verified endotracheal tube placement in all patients. In 68% of patients, endotracheal tube placement was visualized by real-time transtracheal ultrasound. Comparing ultrasound with the combination of auscultation and Capnography, there was a significant difference between the two methods. Median time for ultrasound was 40 s [interquartile range (IQR) 35–48 s] vs. 48 s (IQR 45–53 s), P < 0.0001. Mean difference was −7.1 s in favour of ultrasound [95% confidence interval (CI) −9.4–−4.8 s]. No significant difference was found between ultrasound compared with auscultation alone. Median time for auscultation alone was 42 s (IQR 37–47 s), P = 0.6, with a mean difference of −0.88 s in favour of ultrasound (95% CI −4.2–2.5 s). Conclusions Verification of endotracheal tube placement with ultrasound is as fast as auscultation alone and faster than the standard method of auscultation and Capnography.
Manikam Rishya - One of the best experts on this subject based on the ideXlab platform.
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a feasibility study on bedside upper airway ultrasonography compared to waveform Capnography for verifying endotracheal tube location after intubation
Critical Ultrasound Journal, 2013Co-Authors: Osman Adi, Tan Wan Chuan, Manikam RishyaAbstract:In emergency settings, verification of endotracheal tube (ETT) location is important for critically ill patients. Ignorance of oesophageal intubation can be disastrous. Many methods are used for verification of the endotracheal tube location; none are ideal. Quantitative waveform Capnography is considered the standard of care for this purpose but is not always available and is expensive. Therefore, this feasibility study is conducted to compare a cheaper alternative, bedside upper airway ultrasonography to waveform Capnography, for verification of endotracheal tube location after intubation. This was a prospective, single-centre, observational study, conducted at the HRPB, Ipoh. It included patients who were intubated in the emergency department from 28 March 2012 to 17 August 2012. A waiver of consent had been obtained from the Medical Research Ethics Committee. Bedside upper airway ultrasonography was performed after intubation and compared to waveform Capnography. Specificity, sensitivity, positive and negative predictive value and likelihood ratio are calculated. A sample of 107 patients were analysed, and 6 (5.6%) had oesophageal intubations. The overall accuracy of bedside upper airway ultrasonography was 98.1% (95% confidence interval (CI) 93.0% to 100.0%). The kappa value (Κ) was 0.85, indicating a very good agreement between the bedside upper airway ultrasonography and waveform Capnography. Thus, bedside upper airway ultrasonography is in concordance with waveform Capnography. The sensitivity, specificity, positive predictive value and negative predictive value of bedside upper airway ultrasonography were 98.0% (95% CI 93.0% to 99.8%), 100% (95% CI 54.1% to 100.0%), 100% (95% CI 96.3% to 100.0%) and 75.0% (95% CI 34.9% to 96.8%). The likelihood ratio of a positive test is infinite and the likelihood ratio of a negative test is 0.0198 (95% CI 0.005 to 0.0781). The mean confirmation time by ultrasound is 16.4 s. No adverse effects were recorded. Our study shows that ultrasonography can replace waveform Capnography in confirming ETT placement in centres without Capnography. This can reduce incidence of unrecognised oesophageal intubation and prevent morbidity and mortality. National Medical Research Register NMRR11100810230 .
Saurabh Kumar Das - One of the best experts on this subject based on the ideXlab platform.
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transtracheal ultrasound for verification of endotracheal tube placement a systematic review and meta analysis
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2015Co-Authors: Saurabh Kumar Das, Nang Sujali Choupoo, Rudrashish Haldar, Amitabh LahkarAbstract:Purpose Early confirmation of endotracheal tube placement is of paramount importance to prevent hypoxia and its catastrophic consequences. Despite certain limitations, Capnography is considered the gold standard to evaluate the proper placement of an endotracheal tube. Ultrasound is a novel tool with some definitive advantages over Capnography. It enables a real-time view and can be performed quickly; furthermore, it is independent of pulmonary blood flow and does not require lung ventilation. In this review, we aimed to evaluate the diagnostic accuracy of transtracheal ultrasound in detecting endotracheal intubation.
