title: A pilot study evaluating the use of cervical ultrasound to confirm endotracheal intubation in dogs.
abstract: OBJECTIVE
  To assess the accuracy and usability of cervical ultrasound as a means to confirm endotracheal (ET) intubation in dogs.
  
  
  METHODS
  Randomized pilot study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Six recently euthanized cadaver dogs.
  
  
  METHODS
  Endotracheal and esophageal intubations were randomly performed. The investigators performing the ultrasound examinations were blinded to the type of intubation. Ultrasound examinations were performed in right and left lateral recumbency. The time taken to obtain the images was recorded.
  
  
  RESULTS
  The sensitivity, specificity, positive predictive value, and negative predictive value with their correspondent 95% confidence intervals (CI) were 91.7% (CI, 82.7-96.7), 72.7% (CI, 60.4-84.0%), 78.6% (CI, 68.3-86.8%), and 88.9% (CI, 77.4-95.8%), respectively. The overall test accuracy with its correspondent 95% CI was 82.8% (CI, 75.4-88.1%). The mean time for confirmation with ultrasound was 20.2 seconds (standard deviation, 14.3 s). Cervical ultrasound was significantly more accurate at recognizing ET intubations than esophageal intubations (odds ratio, 4.52; 95% CI, 1.43-14.27; P = 0.010). There was a significant relationship between increase in body weight and accuracy, indicating that the test is more accurate in larger dogs (odds ratio, 1.04; 95% CI, 1.00-1.08; P = 0.042).
  
  
  CONCLUSIONS
  Cervical ultrasound has high sensitivity and moderate specificity for ET intubation, and may be a useful tool to confirm ET intubation in dogs.
authors.affiliation: Department of Clinical Sciences,Bailey Small Animal Teaching Hospital, Auburn University College of Veterinary Medicine, Auburn, AL, 36849. vherreria@rvc.ac.uk.
authors.forename: Vicente J
authors.initials: VJ
authors.lastname: Herreria-Bustillo
authors.affiliation: Department of Clinical Sciences,Bailey Small Animal Teaching Hospital, Auburn University College of Veterinary Medicine, Auburn, AL, 36849.
authors.forename: Kendon W
authors.initials: KW
authors.lastname: Kuo
authors.affiliation: Department of Clinical Sciences,Bailey Small Animal Teaching Hospital, Auburn University College of Veterinary Medicine, Auburn, AL, 36849.
authors.forename: Pierre J
authors.initials: PJ
authors.lastname: Burke
authors.affiliation: Department of Clinical Sciences,Bailey Small Animal Teaching Hospital, Auburn University College of Veterinary Medicine, Auburn, AL, 36849.
authors.forename: Robert
authors.initials: R
authors.lastname: Cole
authors.affiliation: Department of Clinical Sciences,Bailey Small Animal Teaching Hospital, Auburn University College of Veterinary Medicine, Auburn, AL, 36849.
authors.forename: Lenore M
authors.initials: LM
authors.lastname: Bacek
mesh_terms: D000818:Animals; D002102:Cadaver; D004285:Dogs; D004947:Esophagus / Q000000981:diagnostic imaging; D006785:Hospitals, University; D007442:Intubation, Intratracheal / Q000379:methods / Q000662:veterinary*; D010865:Pilot Projects; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014132:Trachea / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000662:veterinary
keywords: CPR; TRUE; canine; cardiopulmonary resuscitation; esophageal intubation; tracheal rapid ultrasound exam