High versus Low Technology in Assessment of Endotracheal Tube Position

November 15, 2016 by Dr. Clemens Leave a Comment

Author: Hans-Joachim Priebe, M.D.

Anesthesiology 12 2016, Vol.125, 1246-1247.

I read with great interest the publication by Ramsingh et al. which elegantly shows that point-of-care ultrasound examination is considerably more accurate than chest auscultation in discriminating between endotracheal and endobronchial intubation. However, several factors limit the practicality of this technique in routine clinical practice. It requires unrestricted access to neck and thorax and considerable operator experience. All ultrasound examinations were performed by anesthesiologists with at least 4-yr postresidency experience who had previously completed at least 50 whole-body point-of-care ultrasound examinations and at least an additional 25 pulmonary tree and lung expansion ultrasound examinations. Even under the optimal study conditions, it took close to 4 min to complete the ultrasound examination in individual cases. The authors appropriately acknowledge these limitations. However, acknowledgment will not eliminate them.

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