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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

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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

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