Avtor/Urednik		Zadel, Sabina; Strnad, Matej; Grmec, Štefek
Naslov		Dokazovanje endotrahealne intubacije s kapnometrijo in ultrazvokom
Prevedeni naslov		Confirming of the endotracheal intubation with capnometry and ultrasound
Tip		članek
Vir		In: Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja 2011. Zbornik 18. mednarodni simpozij o urgentni medicini; 2011 jun 15-18; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Leto izdaje		2011
Obseg		str. 203-6
Jezik		slo
Abstrakt		The aim of endotracheal intubation is to protect the airway by placing the tubus into trachea. There are several methods described by confirming the endotracheal tube position: clinical examination, self-inflating bulb, esophagus detector, capnometry, etc. Clinical examination is an unreliable method for confirming the endotracheal tube position. Capnometry is widely used and quite reliable but it is still not the perfect method. Studies have shown that an ultrasound (US) exam of the chest is a very reliable method for confirming the endotracheal tube position. For our prospective study we would like to gather 100 intubated patients treated in our emergency department. So far we have gathered 29 patients. Personal data, basic parameters, clinical findings, end-tidal CO2 as well as lung sliding and diaphragm moving after intubation were observed and recorded. Approximate results have confirmed the unreability of clinical examination alone and usefulness of capnometry. They have shown great reliability of US for confirming successful intubation. The combination of all methods seems to have 100 % specificity and 100 % sensitivity. The time needed for an US exam is acceptable.
Izvleček		Cilj endotrahealne intubacije je zaščititi dihalno pot z vstavitvijo tubusa v trahejo, pomembna pa je tudi prava globina tubusa v traheji. Do sedaj je opisanih kar nekaj metod potrditve lege tubusa, kot so klinični pregled, samonapihljiva bučka, ezofagealni detektor, kapnometrija, itd. Klinični pregled se je izkazal za nezanesljivo metodo potrditve lege tubusa v traheji. Kapnometrija je razširjena in dokaj zanesljiva pri potrjevanju endotrahealne intubacije, vendar pa tudi to ni popolna metoda. Zelo obetavne rezultate kažejo raziskave, ki preučujejo uporabnost ultrazvoka (UZ) pri potrjevanju pravilne intubacije. S prospektivno študijo želimo na terenu in v ambulanti SNMP Maribor zbrati 100 intubiranih bolnikov. Do sedaj smo zbrali 29 bolnikov, pri katerih smo beležili osebne podatke, osnovne parametre, rezultate kliničnega pregleda, vrednosti CO2 na koncu izdiha (EtCO2) in z UZ po intubaciji opazovali drsenje plevre ter premikanje prepone. Dosedanji okvirni rezultati so potrdili nezanesljivost kliničnega pregleda, dokaj zanesljivo uporabnost kapnometrije ter nakazali zelo veliko zanesljivost UZ pri potrditvi pravilne trahealne intubacije. Kombinacija vseh metod skupaj ima 100 % specifičnost in 100 % senzitivnost. Čas, ki ga preiskovalec porabi za UZ, je sprejemljiv.
Deskriptorji		INTUBATION, INTRATRACHEAL CARDIOPULMONARY RESUSCITATION ULTRASONOGRAPHY BLOOD GAS MONITORING, TRANSCUTANEOUS