Diagnostic Accuracy of Core Stethoscope Auscultation vs. Point of Care Ultrasound in Placement of Endotracheal Tube

Stanford University

Status: Not yet enrolling

Conditions: Intubation Complication

Treatments: Device: Eko CORE Stethoscope; Device: Point of care ultrasound

Study type: Interventional

Funder types: Other

Identifiers

NCT04797520

60429

Details and patient eligibility

About

Misplacement of endotracheal tube (ETT) can have devastating complications for patients, some of which include respiratory failure, atelectasis, and pneumothorax.

There are a number of ways to verify the correct placement of ETT, with the stethoscope auscultation being commonly used despite its low accuracy (60-65%) in distinguishing tracheal from bronchial intubation (4-6). The gold standard techniques include Chest X Ray or fiberoptic bronchoscope (7-8), with a recent study showing point-of-care ultrasound. However, these techniques are expensive, time-consuming, often not readily available and require substantial training before users can reliably utilize them. Given intubation is often performed in urgent clinical settings, a technique that can reliably yet efficiently localize ETT would be beneficial.

Tele-auscultation system via Core stethoscope (Eko, Berkeley, CA) has been shown to be effective in identifying pathologic heart murmur (10) yet its potential use in guiding the correct placement of ETT has not been explored. We set out to study the suitability of Core stethoscope in detecting the correct placement of ETT.

Enrollment: 100 estimated patients

Sex: All

Ages: Under 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Any patients under the age of 18
• Surgery requiring an ETT
• Consent/parental consent to

Exclusion criteria

• Possible difficult airway
• Significant lung pathology
• with any major cardiac anomaly

Trial design

Primary purpose: Prevention

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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100 participants in 1 patient group

Treatment

Other group

Description:

All participants will have placement of ETT confirmed using both Core stethoscope and point-of-care ultrasound

Treatment:

Device: Point of care ultrasound

Device: Eko CORE Stethoscope