• BMC anesthesiology · Jun 2021

    Assessing the accuracy of ultrasound measurements of tracheal diameter: an in vitro experimental study.

    • Ran Ye, Feifei Cai, Chengnan Guo, Xiaocheng Zhang, Dan Yan, Chengshui Chen, and Bin Chen.
    • Department of Ultrasonography, The second Affiliated Hospital and Yuying children's Hospital of Wenzhou Medical University, Wenzhou, 325006, Zhejiang, China.
    • BMC Anesthesiol. 2021 Jun 24; 21 (1): 177.

    BackgroundRecent studies indicate that ultrasound can detect changes in tracheal diameter during endotracheal tube (ETT) cuff inflation. We sought to assess the accuracy of ultrasound measurement of tracheal diameter, and to determine the relationship between tracheal wall pressure (TWP), cuff inflation volume (CIV), and the degree of tracheal deformation.MethodsOur study comprised two parts: the first included 45 porcine tracheas, the second 41 porcine tracheas. Each trachea was intubated with a cuffed ETT, which was connected to an injector and the manometer via a three-way tap. The cuff was inflated and the cuff pressure recorded before and after intubation. The tracheal diameter was measured using ultrasound. This included three separate measurements: outer transverse diameter (OTD), internal transverse diameter (ITD), and anterior tracheal wall thicknesses (ATWT). A precision electronic Vernier caliper was also used to measure tracheal diameter. We calculated TWP and the percentage change of tracheal diameter. The Bland-Altman method, linear regression, and locally weighted regression (LOESS) were used to analyze the data.ResultsThere were strong correlation and agreement for OTD (r = 0.97, P < 0.001) and ITD (r = 0.90, P < 0.001) as measured by ultrasound and by precision electronic Vernier caliper, but a poor correlation for ATWT (r = 0.58, P < 0.001). There was a strong correlation between the percentage change of OTD (OTD%, r = 0.75, P < 0.001) and CIV, the percentage change of ITD (ITD%, r = 0.77, P < 0.001) and CIV, TWP (r = 0.75, P < 0.001) and CIV. And a strong correlation was also found between TWP and OTD% (r = 0.84, P < 0.001), TWP and ITD% (r = 0.84, P < 0.001).ConclusionsUse of ultrasound to measure OTD and ITD is accurate, but is less accurate for ATWT. There is a close correlation between OTD%, ITD%, CIV and TWP.

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