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Abstract PD-005: ASSESSMENT OF ENDOTRACHEAL TUBE TIP POSITION BY BEDSIDE ULTRASOUND IN A PEDIATRIC INTENSIVE CARE UNIT – A DESCRIPTIVE STUDY

Subramani, S.1; Parameswaran, N.1; Ananthakrishnan, R.2; Abraham, S.1; Kt, H.3

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 29
doi: 10.1097/01.pcc.0000537407.16096.2f
Poster Discussion Abstracts
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1JIPMER, Pediatrics, Puducherry, India

2JIPMER, Radiodiagnosis, Puducherry, India

3JIPMER, Biostatistics, Puducherry, India

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Aims & Objectives:

It is important to keep the tip of Endotracheal(ET) tube, mid way between carina and the vocal cords, during mechanical ventilation. Chest X ray(CXR) is considered the gold standard to assess the position of the tip of the ET tube but it has risk of radiation exposure. Ultrasound, which has no radiation exposure, is a promising tool. Hence we evaluated.the utility of bedside assessment of ET tube tip position by ultrasound as compared to chest CXR in mechanically ventilated children

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Methods

Institute’s ethical committee clearance was obtained. After informed consent, children from one month to 60 months of age on mechanical ventilation, were evaluated by bedside ultrasound. Through suprasternal view, three measurements from tip of ET tube to superior border of arch of aorta (situated just above carina) were recorded. The mean of three values was compared with distance between carina and tip of ET tube in CXR using ICC (Intra Class Correlation).

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Results

There were 379 intubations from October 2016 to December 2017. Eighty nine patients who met inclusion criteria were enrolled. The most common indications for invasive ventilation were pneumonia(20.2%), status epilepticus(10.1%) and postoperative status(10.1%). Out of 89, 62(70%) were infants and 55(62%) were boys. ICC agreement co-efficient was 0.78. The most common complication during ultrasound was cough(8.4%). There were no major adverse effects.

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Conclusions

Ultrasound may be a useful bedside tool to assess ET tube position in mechanical ventilated children.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies