Use of Sonography for Rapid Identification of Esophageal and Tracheal Intubations in Adult Patients

Objectives-The aim of this study was to investigate the usefulness of sonography for verifying tracheal tube placement within 3 seconds in adult surgical patients. Methods-This was a blinded prospective randomized study. The anesthesiologist placed the tracheal tube randomly in the trachea (n = 75) or in the esophagus (n = 75) with direct laryngoscopy. A sonographer identified all tracheal and esophageal intubations. The transducer was placed transversely on the neck just superior to the suprasternal notch. The position of the tracheal tube was determined by the sonographer within 3 seconds of tracheal tube placement in the trachea or in the esophagus. Results-We successfully identified 150 correct tracheal tube placements in tracheas and esophagi, resulting in sensitivity of 100% (95% confidence interval, 84%-100%) and specificity of 100% (95% confidence interval, 84%-100%). Conclusions-This investigation shows that sonography for confirming tracheal intubation is a fast and effective technique.