Prediction of Endotracheal Tube Depth by Using Deep Convolutional Neural Networks

NCT05085743 | Completed

• 1 other identifier: 202002007B0
• Study Type: observational
• Target: 595
• Locations: 1 country
• Sites: 1

Brief Summary

Malposition of an endotracheal tube (ETT) may lead to a great disaster. Developing a handy way to predict the proper depth of ETT fixation is in need. Deep convolutional neural networks (DCNNs) are proven to perform well on chest radiographs analysis. The investigators hypothesize that DCNNs can also evaluate pre-intubation chest radiographs to predict suitable ETT depth and no related studies are found. The authors evaluated the ability of DCNNs to analyze pre-intubation chest radiographs along with patients' data to predict the proper depth of ETT fixation before intubation.

Conditions

Intubation; Machine Learning

Keywords

Depth of ETT fixation; Deep convolutional neural networks; Chest radiographs

Outcome Measures

Primary Outcomes (1)

• The lip to carina length predicted by AI model

  The mean absolute error of AI-predicted length in comparison with measured length is used to evaluate AI performance

  1 minute after DCNNs analysis

Secondary Outcomes (1)

• Rate of endotracheal tube malpositioning according to AI model recommendation

  1 minute after DCNNs analysis

Study Arms (2)

Training

Images and related clinical data along with the measured lip to carina length of the training group are fed into and used to fit out deep convolutional neural networks model.

Diagnostic Test: Deep convolutional neural networks analysis

Validation

We evaluate the model accuracy and efficacy of predicting the lip to carina length with images and clinical data of those unforeseen cases in the validation group.

Diagnostic Test: Deep convolutional neural networks analysis

Interventions

Deep convolutional neural networks analysis DIAGNOSTIC_TEST

using Deep convolutional neural networks to analyze pre-intubation chest radiographs along with patients' data to predict the proper depth of ETT fixation

Training; Validation

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients 18 years or older who were orotracheal intubated at Chang Gung Memorial Hospital, Linkou branch, Taiwan.

You may qualify if:

• years or older
• orotracheal intubated within November 2019 to October 2020
• had taken chest radiographs before and within 24hr after intubation

You may not qualify if:

• Bad chest radiographs quality that patients' carina can not be recognized
• Patient with bronchial insertions found in post-intubation films
• Nasal intubation

Sponsors & Collaborators

• Chang Gung Memorial Hospital: lead

Study Sites (1)

Chang Gung Memorial Hospital, Linkou branch

Taoyuan District, Guishan Township, 333, Taiwan

Location

Related Publications (8)

• Lakhani P. Deep Convolutional Neural Networks for Endotracheal Tube Position and X-ray Image Classification: Challenges and Opportunities. J Digit Imaging. 2017 Aug;30(4):460-468. doi: 10.1007/s10278-017-9980-7.

  PMID: 28600640 BACKGROUND

• Lakhani P, Flanders A, Gorniak R. Endotracheal Tube Position Assessment on Chest Radiographs Using Deep Learning. Radiol Artif Intell. 2020 Nov 18;3(1):e200026. doi: 10.1148/ryai.2020200026. eCollection 2021 Jan.

  PMID: 33937852 BACKGROUND

• Eagle CC. The relationship between a person's height and appropriate endotracheal tube length. Anaesth Intensive Care. 1992 May;20(2):156-60. doi: 10.1177/0310057X9202000206.

  PMID: 1595848 BACKGROUND

• Varshney M, Sharma K, Kumar R, Varshney PG. Appropriate depth of placement of oral endotracheal tube and its possible determinants in Indian adult patients. Indian J Anaesth. 2011 Sep;55(5):488-93. doi: 10.4103/0019-5049.89880.

  PMID: 22174466 BACKGROUND

• Techanivate A, Rodanant O, Charoenraj P, Kumwilaisak K. Depth of endotracheal tubes in Thai adult patients. J Med Assoc Thai. 2005 Jun;88(6):775-81.

  PMID: 16083218 BACKGROUND

• Herway ST, Benumof JL. The tracheal accordion and the position of the endotracheal tube. Anaesth Intensive Care. 2017 Mar;45(2):177-188. doi: 10.1177/0310057X1704500207.

  PMID: 28267939 BACKGROUND

• Chong DY, Greenland KB, Tan ST, Irwin MG, Hung CT. The clinical implication of the vocal cords-carina distance in anaesthetized Chinese adults during orotracheal intubation. Br J Anaesth. 2006 Oct;97(4):489-95. doi: 10.1093/bja/ael186. Epub 2006 Jul 27.

  PMID: 16873383 BACKGROUND

• Conrardy PA, Goodman LR, Lainge F, Singer MM. Alteration of endotracheal tube position. Flexion and extension of the neck. Crit Care Med. 1976 Jan-Feb;4(1):8-12. doi: 10.1097/00003246-197601000-00002. No abstract available.

  PMID: 1253616 BACKGROUND

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: medical doctor

Study Record Dates

• First Submitted: September 24, 2021
• First Posted: October 20, 2021
• Study Start: November 1, 2019
• Primary Completion: October 31, 2020
• Study Completion: October 31, 2020
• Last Updated: October 20, 2021

Record last verified: 2021-10

Locations

TW (1)