Can Endotracheal Tube Fluctuation With Epigastric Compression Be Used as a Confirmation Method for Endotracheal Intubation?

NCT06542406 | Completed

• 1 other identifier: DuzceUniversityEM
• Study Type: interventional
• Target: 78
• Locations: 1 country
• Sites: 1

Brief Summary

Endotracheal intubation (ETE) may also need to be performed outside the hospital as advanced airway management. In such cases, facilities such as imaging methods, ultrasound or capnography may not be available and only traditional methods such as auscultation of lung sounds, auscultation of the epigastric region without hearing airflow, observation of chest expansion after ventilation, observation of water vapor in the tube may have to be used. Despite all these observational methods and equipment used, it is recommended to keep in mind that there may be errors and to try to provide confirmation with more than one method. Especially in disaster situations where technological infrastructure is not available and sometimes outside the hospital, the use of traditional methods based on examination may be of vital importance. The traditional methods mentioned above are mostly used to detect tracheal localization and to exclude esophageal localization. In our observations in patients with cardiopulmonary arrest, the investigators noticed that in the case of esophageal placement of the tube, manual compression of the epigastric region produced a fluctuation in the tube and valved balloon caused by airflow. The investigators thought that this could be a method to confirm esophageal placement. The aim of this study was to investigate the usefulness of epigastric manual compression in the confirmation of esophageal placement of the tube.

Conditions

Intubation, Intratracheal

Keywords

endotracheal intubation; esophageal placement; epigastric fluctuation

Outcome Measures

Primary Outcomes (1)

• Confirmation with ultrasonography: Successful or Failed

  Fluctuation with Epigastric Compression: Yes or No Failed Successful Failed

  13 months

Study Arms (1)

Endotracheal intubation

OTHER

Patients admitted to the emergency department between 01/05/2021 and 30/05/2022, who were older than 18 years of age and who underwent ETE outside the hospital or within the first hour of arrival to the emergency department were included in the study.

Device: Endotracheal intubation

Interventions

Endotracheal intubation DEVICE

The first 40 successful and the first 40 unsuccessful ETE procedures were included in the study.

Endotracheal intubation

Eligibility Criteria

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

You may qualify if:

• Older than 18 years of age
• Underwent ETE outside the hospital or within the first hour of arrival to the emergency department

You may not qualify if:

• Patients in whom ETE was previously confirmed by USG or PETCO2,
• Patients intubated at external centers
• Patients who had known airway stenosis

Sponsors & Collaborators

• Duzce University: lead

Study Sites (1)

Duzce University

Düzce, Turkey (Türkiye)

Location

Related Publications (3)

• Farrokhi M, Yarmohammadi B, Mangouri A, Hekmatnia Y, Bahramvand Y, Kiani M, Nasrollahi E, Nazari-Sabet M, Manoochehri-Arash N, Khurshid M, Mosalanejad S, Hajizadeh V, Amani-Beni R, Moallem M, Farahmandsadr M. Screening Performance Characteristics of Ultrasonography in Confirmation of Endotracheal Intubation; a Systematic Review and Meta-analysis. Arch Acad Emerg Med. 2021 Oct 26;9(1):e68. doi: 10.22037/aaem.v9i1.1360. eCollection 2021.

  PMID: 34870234 RESULT

• Li X, Zhang J, Karunakaran M, Hariharan VS. Diagnostic accuracy of ultrasonography for the confirmation of endotracheal tube intubation: a systematic review and meta-analysis. Med Ultrason. 2023 Mar 30;25(1):72-81. doi: 10.11152/mu-3594. Epub 2022 Jun 3.

  PMID: 36780595 RESULT

• Kramer-Johansen J, Dorph E, Steen PA. Detection of carbon dioxide in expired air after oesophageal intubation; the role of bystander mouth-to-mouth ventilation. Acta Anaesthesiol Scand. 2008 Jan;52(1):155-7. doi: 10.1111/j.1399-6576.2007.01503.x. Epub 2007 Nov 12.

  PMID: 17999713 RESULT

MeSH Terms

Interventions

Intubation, Intratracheal

Intervention Hierarchy (Ancestors)

Airway Management; Therapeutics; Intubation; Investigative Techniques

Study Officials

• Mustafa Boğan, MD

  Duzce University, School of Medicine, Emergency Department

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Researcher Assistant in Emergency Department

Study Record Dates

• First Submitted: July 26, 2024
• First Posted: August 7, 2024
• Study Start: February 18, 2021
• Primary Completion: March 4, 2023
• Study Completion: March 4, 2023
• Last Updated: August 7, 2024

Record last verified: 2024-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)