Article Data

  • Views 2090
  • Dowloads 173

Original Research

Open Access

The Importance of Bedside Ultrasonography in Confirming the Location of Endotracheal Tube


1Dr., Çukurova Üniversity, Pediatrics, Emergency Care Unit, Balcali Hospital, Adana-Turkey

2 Professor, Çukurova Üniversity, Pediatrics, Emergency Care Unit, Balcali Hospital, Adana-Turkey

3 Dr., Çukurova Üniversity, Pediatrics, Emergency Care Unit, Balcali Hospital, Adana-Turkey

4 Dr., Çukurova Üniversity, Pediatrics, Intensive Care Unit, Balcali Hospital, Adana-Turkey

5 Professor, Çukurova Üniversity, Pediatrics, Intensive Care Unit, Balcali Hospital, Adana-Turkey

DOI: 10.22514/SV152.092019.4 Vol.15,Issue 2,September 2019 pp.30-33

Published: 20 September 2019

*Corresponding Author(s): OZLEM TOLU KENDIR E-mail:


Objective. Endotracheal intubation may be associated with lethal complications when not applied in appropriate manner. In this study, we aimed to examine the efficiency of transcricoid and pulmonary ultrasonog-raphy in confirming the position of the tube in comparison with classical methods. Methods. This study was carried out be-tween 2016 and 2017 in Turkey and was registered in Clinical Trials under number NCT03081221. The location of the tube was confirmed using methods such as monitor-ing the vocal cords during direct laryngo-scopy, condensation on endotracheal tube during respiration, epigastric-pulmonary auscultation, radiography and capnometry. After that, the transcricoid and pulmonary ultrasonography were implemented by the blinded pediatric emergency care special-ist. 

Results. 64 cases who needed advanced airway requirements were involved in this study. The double-line appearance could not be obtained from one patient only when using transcricoid ultrasonography, but the bilateral pleural shift movement was observed among all the cases by us-ing pulmonary ultrasonography (sensitive: 98%-100%). 

Conclusion. The determination of endoe-sophageal, endotracheal and endobronchi-al intubations can be easily made by using transcricoid and pulmonary ultrasonog-raphy. The use of ultrasonography may significantly contribute to critical airway management as fast, accurate and on time. 


Endobronchial intubation, En-dotracheal intubation, Ultrasonography

Cite and Share

OZLEM TOLU KENDIR,HAYRI LEVENT YILMAZ,SEVCAN BILEN,SINEM SARI GOKAY,İLKNUR TOLUNAY,AHMET KAGAN OZKAYA,RIZA DINCER YILDIZDAS. The Importance of Bedside Ultrasonography in Confirming the Location of Endotracheal Tube. Signa Vitae. 2019. 15(2);30-33.


1. Rudraraju P, Eisen LA. Confirmation of endotracheal tube position: A narrative review. J Intensive Care 2009;25(5): 283-92.

2. Moghadam HZ, Shrifi MD, Rajabi H, Mousavi Bazaz M, Alamdaran A, Jafari N, et al. Screening characteristics of bedside ultrasonog-raphy in confirming endotracheal tube placement; a diagnostic accuracy study. Emerg (Tehran) 2017;5(1):e19.

3. Garg R, Gupta A. Ultrasound: A promising tool for contemporary airway management. World J Clin Cases 2015;3(11):926-9.

4. Budhram G, Murman D, Lutfy L, Sullivan A. Sonographic confirmation of intubation comparison of 3 methods in a pig model. J Ultrasound Med 2014;33:1925-9.

5. Sustic A. Role of ultrasound in the airway management of critically ill patients. Crit Care Med 2007;35(5);173-7.

6. Marin JR, Lewiss RE. Point-of-care ultrasonography by pediatric emergency medicine physicians. Pediatrics 2015;135(4):1113-22.

7. Chenkin J, McCartney CL, Jelic T, Romano M, Heslop C, Bandiera G. Defining the learning curve of point-of-care ultrasound for confirming endotracheal tube placement by emergency physicians. Crit Ultrasound J 2015;7(1):14.

8. Gottlieb M, Bailitz JM, Chistian E, Russel FM, Ehrman R, Khishfe B et al.Accuracy of a novel ultrasound technique for confirmation of endotracheal intubation by expert and novice emergency physicians. West J Emerg Med 2014 Nov; 15(7): 834–9.

9. Pfeıffer P, Bache S, Iabye L, Rudolph S, Rovsing L, Borglum J. Verification of endotracheal intubation in obese patient-temporal com-parison of ultrasound vs. auscultation and capnography. Acta Ansesth Scand 2012;56:572-6.

10. Schmölzer GM, O’Reilly M, Davis PG, Cheung PY. Confirmation of correct tracheal placement in newborn infants. Resuscitation 2013;84(6):731-7.

11. Takeda T, Tanigawa K, Tanaka H, Hayashi Y, Goto E, Tanaka K. The assesment of three methods to verify tracheal tube placement in the emergency setting. Resuscitation 2003;56:153-7.

12. Adi O, Chuan TW, Riahya M. A Feasibility study on bedside upper airway ultrasonography compared to waveform capnography for verifying endotracheal tube location after intubation. Crit Ultrasound J 2013;5(1):5-7.

13. Bond A. Obesity and difficult intubation. Anaesth Intensive Care 1993; 21:828–830.

14. Park SC, Ryu JH, Yeom SR, Jeong JW, Cho SJ. Confirmation of endotracheal intubation by combined ultrasonographic methods in the emergency department. Emerg Med Australas 2009; 21:293-7.

15. Tsung JW, Fenster D, Kessler DO, Novik J. Dynamic anatomic relationship of the esophagus and trachea on sonography. J Ultrasound Med 2012;31:1365-70.

16. Hoffmann B, Gullet JP, Hill H, Fuller D, Westergaard MC, Hosek WT et al. Bedside ultrasound of the neck confirms endotracheal tube position in emergency intubations. Ultraschall Med 2014;35(5):451-8.

17. Abbasi S, Farsi D, Zare MA, Hajimohammadi M, Rezai M, Hafezimoghadam P. Direct ultrasound methods: a confirmatory tech-nique for proper endotracheal intubation in the emergency department. Eur J Emerg Med 2015;22:10-6

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time