Using ultrasound of the windpipe for early confirmation of tube placement in patients receiving general anaesthesia and comparison of its results with end-tidal capnography which is the gold standard

Recruiting

Conditions: for Elective surgeries

Registration Number: CTRI/2018/03/012409

Lead Sponsor: Mahima Nayyar

Brief Summary: It is important to confirm proper placement of endotracheal(ET) tube as inadvertent esophageal intubation is associated with catastrophic consequences. Quantitative waveform capnography is currently the gold standard and most sensitive method for confirmation of ET tube.However it has some limitations like its accuracy may be compromised in patients suffering from pulmonary embolism or those in cardiac arrest. Also respiration must be maintained for several breaths to accurately confirm the ET tube placement and this can lead to fatal regurgitation and aspiration in full stomach patients being ventilated with a misplaced esophageal tube. Thirdly capnography may provide false negative results in case of severe airway obstruction or use of epinephrine. Ultrasound guided confirmation of correct ET tube placement has been described in adults with high sensitivity and specificity in both controlled operating room conditions and emergency or ICU settings.Ultrasound is a novel tool, provides real time view and can be performed quickly. Furthermore it is independent of pulmonary blood flow and does not require lung ventilation. We plan to do prospective observational study to compare upper airway(tracheal) USG with reference to capnography( the gold standard) for early confirmation of ET tube placement.

Detailed Description: Not available

Recruitment & Eligibility

Status: Open to Recruitment

Sex: All

Target Recruitment: 150

Inclusion Criteria

ASA 1 and 2 Modified Mallampati grading less than 3 Elective surgeries Mouth opening > 3 cm.

Exclusion Criteria

Neck tumours/visible neck swelling History of neck operation/trauma/radiation Limited neck extention Neck diameter >40 cm Emergency surgeries High risk of aspiration Pregnancy Anticipated difficult airway.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Confirmation of endotracheal tube in trachea via ultrasonography as an alternative to the gold standard, capnography.	Measure time taken for confirmation of endotracheal tube by waveform capnography and airway ultrasonography

Secondary Outcome Measures

Name	Time	Method
Ultrasound help in detection of correct placement of endotracheal tube even prior to capnography which is the gold standard	To compare sensitivity and specificity for airway ultrasonography and capnography

Trial Locations

Locations (1): Dr.B.L.Kapur Superspeciality Hospital
🇮🇳
Delhi, DELHI, India
Dr.B.L.Kapur Superspeciality Hospital
🇮🇳Delhi, DELHI, India
Mahima Nayyar
Principal investigator
8800386681
patmahimanayyar@gmail.com