Reliability of ultrasound for rapid identification of esophageal intubation in patients with difficult airway

Abstract

Objective To evaluate the reliability of ultrasound for rapid identification of esophageal intubation in the patients with difficult airway. Methods Twenty-one patients requiring orotracheal intubation, aged 20-75 yr, with body mass index of 25-32 kg/m2, of ASA physical status Ⅰ or Ⅱ, Cormack-Lehane grade Ⅲ or Ⅳ under direct laryngoscope, undergoing elective general anesthesia, were selected. The carotid artery, trachea and esophagus were identified by ultrasonic scanning at suprasternal notch before induction of anesthesia. After induction of anesthesia, tracheal intubation was performed. During intubation, ultrasound was performed to detect esophageal intubation. After intubation, mechanical ventilation was performed. Auscultation of bilateral breath sounds was carried out to evaluate the tube position. The position of the tube was subsequently determined through partial pressure of end-tidal CO2 monitoring. Results The sensitivity and specificity of ultrasound in identifying esophageal intubation were both 100% in the patients with difficult airway. Conclusion Ultrasound can rapidly and effectively identify esophageal intubation in the patients with difficult airway. Key words: Ultrasonography; Intubation, intratracheal; Esophagus; Intraoperative complications