In neonates who have been successfully intubated can ultrasound be used to accurately confirm endotracheal tube tip position?

摘要

A neonate has just been intubated on the Neonatal Intensive Care Unit (NICU). The tube has been confirmed to be within the trachea through a combination of clinical and physiological signs. These include observing for symmetrical chest movement, listening for air leak at the mouth and auscultation of the chest and abdomen. Capnography is positive for end-tidal CO2, and the patient has shown a clinical improvement in colour, saturations and heart rate. A chest X-ray (CXR) is requested to confirm that the endotracheal tube (ET) tip sits below the upper border of the T1 vertebral body and above the lower border of the T2 vertebral body. While waiting for the radiographer to arrive you wonder whether the NICU’s ultrasound (US) machine could be used to confirm the ET tip position.