Abstract：
After endotracheal intubation is performed, the location of the endotracheal tube (ETT) is confirmed followed by assessment of ETT depth. Physical examination can be unreliable and chest radiographs can lead to delayed recognition. Ultrasound may facilitate rapid determination of ETT depth at the bedside; however, the ideal technique is unknown.
This was a randomized trial comparing the static versus dynamic technique for ETT depth assessment using a cadaver model. The ETT was randomized to correct versus deep placement. Seven physicians blinded to ETT location assessed the location using static (direct visualization of an inflated cuff) versus dynamic (active inflation of the ETT cuff) visualization. Outcomes included diagnostic accuracy, time to identification, and operator confidence with subgroup analyses by physician ultrasound experience.
420 total assessments were performed. The static technique was 99.1% (95% CI 94.8%-100%) sensitive and 97.1% (95% CI 91.9%-99.4%) specific. The dynamic technique was 100% (95% CI 96.7%-100%) sensitive and 100% (95% CI 96.7%-100%) specific. Time to identification was faster for the static technique (6.6 s; 95% CI 5.9-7.4 s) versus the dynamic technique (8.7 s; 95% CI 8.0-9.5 s). Operator confidence was lower for the static technique (4.4/5.0; 95% CI 4.3-4.5) versus the dynamic technique (4.7/5.0; 95% CI 4.6-4.8). There were no differences in the findings when assessed among expert or non-expert sonographers.
There was no statistically significant difference in the accuracy of ETT depth identification between the static or dynamic technique. However, utilizing the dynamic technique showed a statistically significant improvement in sonographer confidence and a concomitant increase in time to identification.
This was a randomized trial comparing the static versus dynamic technique for ETT depth assessment using a cadaver model. The ETT was randomized to correct versus deep placement. Seven physicians blinded to ETT location assessed the location using static (direct visualization of an inflated cuff) versus dynamic (active inflation of the ETT cuff) visualization. Outcomes included diagnostic accuracy, time to identification, and operator confidence with subgroup analyses by physician ultrasound experience.
420 total assessments were performed. The static technique was 99.1% (95% CI 94.8%-100%) sensitive and 97.1% (95% CI 91.9%-99.4%) specific. The dynamic technique was 100% (95% CI 96.7%-100%) sensitive and 100% (95% CI 96.7%-100%) specific. Time to identification was faster for the static technique (6.6 s; 95% CI 5.9-7.4 s) versus the dynamic technique (8.7 s; 95% CI 8.0-9.5 s). Operator confidence was lower for the static technique (4.4/5.0; 95% CI 4.3-4.5) versus the dynamic technique (4.7/5.0; 95% CI 4.6-4.8). There were no differences in the findings when assessed among expert or non-expert sonographers.
There was no statistically significant difference in the accuracy of ETT depth identification between the static or dynamic technique. However, utilizing the dynamic technique showed a statistically significant improvement in sonographer confidence and a concomitant increase in time to identification.
摘要：
背景：气管插管后，确认气管导管(ETT)的位置,然后评估ETT深度.体格检查可能不可靠，胸片可能导致识别延迟。超声可能有助于快速确定床边的ETT深度；但是，理想的技术是未知的。
方法：这是一项随机试验，比较了静态与动态技术对尸体模型进行ETT深度评估。将ETT随机进行校正与深层放置。对ETT位置视而不见的七名医生使用静态(充气袖带的直接可视化)与动态(ETT袖带的主动充气)可视化来评估位置。结果包括诊断准确性，识别时间，和操作者信心与亚组分析由医生超声经验。
结果：共进行了420次评估。静态技术的敏感性为99.1%(95%CI94.8%-100%),特异性为97.1%(95%CI91.9%-99.4%)。动态技术100%(95%CI96.7%-100%)敏感,100%(95%CI96.7%-100%)特异。静态技术（6.6s;95％CI5.9-7.4s）比动态技术（8.7s;95％CI8.0-9.5s）更快。静态技术（4.4/5.0；95％CI4.3-4.5）的操作员置信度低于动态技术（4.7/5.0；95％CI4.6-4.8）。在专家或非专家超声医师之间进行评估时，结果没有差异。
结论：静态或动态技术之间的ETT深度识别的准确性没有统计学上的显着差异。然而,利用动态技术显示，超声医师的信心在统计学上显着提高，同时识别时间也随之增加。
方法：这是一项随机试验，比较了静态与动态技术对尸体模型进行ETT深度评估。将ETT随机进行校正与深层放置。对ETT位置视而不见的七名医生使用静态(充气袖带的直接可视化)与动态(ETT袖带的主动充气)可视化来评估位置。结果包括诊断准确性，识别时间，和操作者信心与亚组分析由医生超声经验。
结果：共进行了420次评估。静态技术的敏感性为99.1%(95%CI94.8%-100%),特异性为97.1%(95%CI91.9%-99.4%)。动态技术100%(95%CI96.7%-100%)敏感,100%(95%CI96.7%-100%)特异。静态技术（6.6s;95％CI5.9-7.4s）比动态技术（8.7s;95％CI8.0-9.5s）更快。静态技术（4.4/5.0；95％CI4.3-4.5）的操作员置信度低于动态技术（4.7/5.0；95％CI4.6-4.8）。在专家或非专家超声医师之间进行评估时，结果没有差异。
结论：静态或动态技术之间的ETT深度识别的准确性没有统计学上的显着差异。然而,利用动态技术显示，超声医师的信心在统计学上显着提高，同时识别时间也随之增加。
