title: [Usefulness of bedside ultrasound compared to capnography and X-ray for tracheal intubation].
abstract: OBJECTIVE
  The aim of this study was to assess the usefulness of bedside ultrasound compared to capnography and X-ray for endotracheal intubation in children and newborns.
  
  
  METHODS
  Hemodynamically stable children intubated in pedriatric and neonatal intensive care unit were included. Endotracheal tube insertion was checked after every intubation attempt by tracheal ultrasound and capnography simultaneously. The endotracheal tube insertion depth was then checked by assesment of lung sliding by thoracic ultrasound. Thereafter, Chest X-ray was performed and interpreted as usual. Time to perform each technique was recorded.
  
  
  RESULTS
  The study included 31 intubations in 26 patients (15 in PICU and 16 in NICU). There were no statistically significant differences between tracheal ultrasound and capnography or between thoracic ultrasound and x-ray in identifying the correct endotracheal intubation and assessment of endotracheal tube insertion depth, respectively. Sensibility and specificity of ultrasound compared to capnography was 92% and 100%, and 100% and 75% compared to X-ray. Ultrasound was significantly slower compared to capnography [12 (4-16) vs 6 (3-12) seconds; P<.001] and significantly quicker compared to X-ray [0.22 (0.17-0.40) vs. 20 (17-25) minutes, P<.001].
  
  
  CONCLUSIONS
  Ultrasound appears to be as effective as capnography, although slower, for identifying endotracheal intubation. Ultrasound may be useful in clinical situations, such as cardiopulmonary resuscitation where capnography is less reliable. Ultrasound is as effective and quicker than X-ray for assessment of endotracheal tube insertion depth, and it may contribute to decrease the routine use of X-ray after tracheal intubation.
authors.affiliation: Servicio Pediatría, Complejo Asistencial Universitario de León, León, España. Electronic address: paulaalonsoquintela@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Alonso Quintela
authors.affiliation: Servicio de Cardiología, Complejo Asistencial Universitario de León, León, España; Unidad de Cuidados Intensivos Pediátricos, Complejo Asistencial Universitario de León, León, España.
authors.forename: I
authors.initials: I
authors.lastname: Oulego Erroz
authors.affiliation: Servicio Pediatría, Complejo Asistencial Universitario de León, León, España.
authors.forename: M
authors.initials: M
authors.lastname: Mora Matilla
authors.affiliation: Servicio de Neonatología, Complejo Asistencial Universitario de León, León, España; Unidad de Cuidados Intensivos Pediátricos, Complejo Asistencial Universitario de León, León, España.
authors.forename: S
authors.initials: S
authors.lastname: Rodríguez Blanco
authors.affiliation: Centro de Salud Ponferrada IV, Complejo Asistencial Universitario de León, León, España.
authors.forename: D
authors.initials: D
authors.lastname: Mata Zubillaga
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Complejo Asistencial Universitario de León, León, España.
authors.forename: L
authors.initials: L
authors.lastname: Regueras Santos
mesh_terms: D000293:Adolescent; D000465:Algorithms; D019296:Capnography; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000379:methods*; D000067716:Point-of-Care Testing; D011446:Prospective Studies; D014132:Trachea / Q000000981:diagnostic imaging*
keywords: Bedside ultrasound; Capnografía; Capnography; Children; Ecografía; Intubación traqueal; Neonatos; Newborn; Niños; Radiografía; Tracheal intubation; X-ray
vernacular_title: Utilidad de la ecografía comparada con la capnografía y la radiografía en la intubación traqueal.