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The concordance of ultrasound technique versus X-ray to confirm endotracheal tube position in neonates

Journal of Perinatology volume 35, pages 481–484 (2015)Cite this article

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Abstract

Objective:

Given the distressingly high incidence of ETT malposition in the neonatal population, patients are exposed to ionizing radiation to confirm endotracheal tube (ETT) position. Our objective is to determine if ultrasound technique is concordant with X-ray in determining whether an ETT is deeply positioned or not.

STUDY DESIGN:

Prospective observational clinical trial. After obtaining informed consent, patients with an ETT who required X-ray for clinical reasons underwent sonographic evaluation of the ETT by an ultrasound technologist or pediatric radiologist, usually within the hour.

Results:

A total of 56 image pairs were obtained from 29 patients. Ninety-eight percent of the ultrasound/X-ray image pairs were suitable for analysis. The concordance of ultrasound with X-ray to identify deeply and not deeply positioned ETTs was 95% (53/56). The sensitivity of ultrasound to detect deeply positioned ETTs on X-ray was 86% (6/7). The specificity of ultrasound to detect ETTs that were not deeply positioned on X-ray was 96% (47/49).

Conclusions:

As the largest clinical trial of its kind to date, with the greatest number of ultrasound operators, we have further established US as a feasible imaging modality to determine whether an ETT is deeply positioned or not.

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Acknowledgements

The primary author is a fellow in training and thanks Dr Barbara Dangman and Dr Joaquim Pinheiro for their unwavering commitment toward the development and completion of this clinical trial. Without their mentorship, this trial would not be possible. Additionally, the success of this trial was dependent on the participation of the staff of ultrasound technologists at The Children’s Hospital at Albany Medical center and they are due special recognition for their efforts.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, Albany Medical College, Albany, NY, USA

    R Chowdhry

  2. Department of Radiology, Albany Medical College, Albany, NY, USA,

    B Dangman

  3. Department of Pediatrics, Division of Neonatology, Albany Medical College, Albany, NY, USA,

    J M B Pinheiro

Authors
  1. R Chowdhry
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  2. B Dangman
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  3. J M B Pinheiro
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Corresponding author

Correspondence to R Chowdhry.

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The authors declare no conflict of interest.

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Chowdhry, R., Dangman, B. & Pinheiro, J. The concordance of ultrasound technique versus X-ray to confirm endotracheal tube position in neonates. J Perinatol 35, 481–484 (2015). https://doi.org/10.1038/jp.2014.240

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