Acute Crit Care.  2022 May;37(2):224-229. 10.4266/acc.2021.00787.

Determining the diagnostic value of tracheal intubation by palpation and auscultation methods compared to the chest X-ray method in children

• Masoumi G
• Mansouri M
• Fathali O

• KMID: 2531680
• DOI: http://doi.org/10.4266/acc.2021.00787

Abstract

Background
It is important to determine the proper location of tracheal tube for proper ventilation. In this study, we compared the diagnostic value of tracheal intubation with two methods of palpation and auscultation with chest X-ray (CXR) method in pediatric.
Methods
In this interventional study, 80 patients under 6 years of age were included. After tracheal intubation appropriate depth of tracheal tube was determined by auscultation and recorded, then by palpation depth of tracheal tube determined and tube was fixed. The length of the tube was calculated with the standard formula based on age. After surgery, CXR was taken and, according to the landmark, the distance from the end of the tube to the anterior lower tooth was recorded.
Results
Interclass correlation coefficient (ICC) between the palpation method and the standard method in the number of fixing tracheal intubation was 0.573, which shows the average and significant correlation between these two methods in determining the fixed number of tracheal intubation. ICC between the auscultation and the standard method in fixing tracheal intubation number was 0.430, which shows the average and significant agreement between these two methods in determining the fixed number of tracheal intubation. There is no significant relationship between sex and the average number of fixing tracheal intubation in all methods.
Conclusions
This study has shown that both palpation and auscultation methods are appropriate, but with a slightly higher palpation ICC, the palpation can be considered relatively better.

Keyword

auscultation; chest X-ray; palpation; pediatrics

Figure

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  Figure 1. The Bland-Altman plot for correlation of the mean tracheal tube fixation numbers by the calculation and palpation methods. Horizontal line: the mean tracheal tube fixation numbers in the calculation and palpation methods; Vertical line: the difference in mean tracheal tube fixation numbers (calculation-palpation methods). SD: standard deviation.

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  Figure 2. The Bland-Altman plot for correlation of the mean tracheal tube fixation numbers by the calculation and auscultation methods. Horizontal line: the mean tracheal tube fixation numbers in the calculation and auscultation methods; Vertical line: the difference in mean tracheal tube fixation numbers (calculation-auscultation methods). SD: standard deviation.

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