Ultrasound-guided lung sliding sign to confirm optimal depth of tracheal tube insertion in young children

Abstract

BackgroundThe tip of the tracheal tube should lie at the mid-tracheal level after tracheal intubation in paediatric patients. Auscultation does not guarantee optimal positioning of the tracheal tube. We compared auscultation and the ultrasound-guided lung sliding sign to confirm optimal positioning of the tracheal tube in paediatric patients. MethodsWe studied 74 paediatric patients aged 0–24 months of ASA physical status 1–3 who were scheduled for elective surgery under general anaesthesia. All were randomly assigned to one of two groups: depth of tracheal tube confirmed by auscultation (Group A) or using the ultrasound-guided lung sliding sign (Group S). ResultsOptimal positioning of the tracheal tube was observed in 32 of 37 (87%) subjects in Group S and 24 of 37 (65%) subjects in Group A (difference in proportion, 22%; 95% confidence interval, 2–39%; P=0.030). Optimal depth correlated with patient height (adjusted coefficient=0.888, P<0.001). ConclusionsIn paediatric patients younger than 24 months, use of the ultrasound-guided lung sliding sign was more accurate than auscultation for optimal positioning of the tracheal tube. Clinical trial registrationKCT 0003015.