Dergiler / Ulusal Travma ve Acil Cerrahi Dergisi / 2019 / Cilt: 25 - Sayı: 4

Role of ultrasonography in determining the cricothyroid membrane localization in the predicted difficult airway

Öngörülen zor havayolunda krikotiroit membran lokalizasyonunun belirlenmesinde ultrasonografinin rolü

Sayfa
355–360
DOI
—
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Furthermore, the results gathered with US are in a closer range to CT scan.

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:BACKGROUND: The aim of this study was to investigate the success rates of ultrasound (US) and palpation methods in identifying the cricothyroid membrane (CTM), and compare the results with the gold standard method—computed tomography (CT) scan.
📊
Temel Bulgular & Veri:METHODS: A total of 110 patients were included into the study.
💡
Sonuç & Katkı:Furthermore, the results gathered with US are in a closer range to CT scan.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

BACKGROUND: The aim of this study was to investigate the success rates of ultrasound (US) and palpation methods in identifying the cricothyroid membrane (CTM), and compare the results with the gold standard method—computed tomography (CT) scan. METHODS: A total of 110 patients were included into the study. The midline was estimated by a single investigator using both the US and palpation methods from the prominence of the thyroid cartilage to the center of the sternal notch, and the distance was measured (in millimeters) between the two points: Point A (the midpoint of CTM) and Point B (the inferior process of thyroid cartilage). Furthermore, the distance between Point A and Point B was calculated using the CT images. Time taken to assess the CTM by using US and palpation methods were recorded. Moreover, difficulty in using the two methods was measured with the visual analog scale (VAS). In addition, demographic and morphometric characteristics of the patients were noted. RESULTS: The CTM was detected accurately in 50 (45.5%) patients with palpation and 82 (74.5%) with US. In the Bland–Altman analysis, a better agreement was observed with US. The time to assess CTM was shorter with US than with palpation, p<0.001. The VAS scores for the palpation and US difficulty were 5.13±1.1 and 3.32±0.9 (p<0.001), respectively. While an increased neck circumference and thyromental distance were found to be independent risk factors for the success rates of determining the CTM by palpation, body mass index is an independent risk factor for US. CONCLUSION: Localization of the CTM is more accurate and easier with US than palpation. Furthermore, the results gathered with US are in a closer range to CT scan.

Abstract

AMAÇ: Bu çalışmanın amacı, ultrason (US) ve elle muayene yöntemlerinin başarı oranlarını araştırmak ve bilgisayarlı tomografiye (BT) karşı US ile elle muayenenin kıyaslanarak krikotiroid membranın (KTM) tanımlamak. GEREÇ VE YÖNTEM: Çalışmaya 110 hasta alındı. Tiroit kartilajın çıkıntısından sternal çentiğin ortasına kadar düzlemde orta hat belirlendikten sonra, iki nokta arasındaki mesafe (milimetre) ölçüldü. A noktası-KTM’nin orta noktası ile B noktası-tiroit kartilajın inferiyor kısmı arasındaki mesafe (milimetre) US ve elle muayene ile tek bir araştırmacı tarafından işaretlenerek ölçüldü. Ayrıca A noktası ile B noktası arasındaki mesafe BT kullanılarak hesaplandı. US ve elle muayene ile KTM’in belirlenmesi için geçen süre ve VAS skoru kullanılarak her iki yöntemin kolaylığı kaydedildi. Ek olarak hastaların demografik ve morfometrik karakteristikleri not edildi. BULGULAR: Krikotiroit membran elle muayene ile 50 hastada (%45.5) ve US ile 82 (%74.5) hastada doğru olarak saptandı. Blant-Altman analizine göre US ile elle muayeneye göre daha iyi uyum gözlendi. KTM yerinin belirlenmesi için geçen süre US ile elle muayeneden daha kısa idi (p<0.001). VAS değerleri elle muayene ve US ile sırasıyla 5.13±1.1, 3.32±0.9 bulundu (p<0.001). Artan boyun kalınlığı ve tiromental mesafe elle muayene başarısını etkileyen risk faktörü olarak saptanırken US için risk faktörü olarak vücut kitle indeksi (VKİ) bulundu. TARTIŞMA: Krikotiroit membranın lokalizasyonu US ile elle muayeneden daha doğru ve kolay saptanmıştır. Ayrıca US ile bulunan sonuçlar BT’ye daha yakın bulunmuştur.

🔖

Bu Makaleye Atıf Yap

ALTUN, D., ALI, A., KOLTKA, K., BÜGET, M., ÇELİK, M., DORUK, C., ÇAMCI, A. E. (2019). Role of ultrasonography in determining the cricothyroid membrane localization in the predicted difficult airway. Ulusal Travma ve Acil Cerrahi Dergisi, Cilt: 25 - Sayı: 4, 355–360. https://ajindex.com/articles/323586

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (14)

  1. Cook TM, Woodall N, Frerk C
  2. Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth 2011
  3. 617– 31. [CrossRef ] 2. Langvad S, Hyldmo PK, Nakstad AR, Vist GE, Sandberg M. Emergency cricothyrotomy-a systematic review. Scand J Trauma Resusc Emerg Med 2013
  4. [CrossRef ] 3. Erlandson MJ, Clinton JE, Ruiz E, Cohen J. Cricothyrotomy in the emergency department revisited. J Emerg Med 1989
  5. 115–8. [CrossRef ] 4. Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth 2015
  6. 827–48. 5. Lamb A, Zhang J, Hung O, Flemming B, Mullen T, Bissell MB, et al. Accuracy of identifying the cricothyroid membrane by anesthesia trainees and staff in a Canadian institution. Can J Anaesth 2015
  7. 495–503. 6. You-Ten KE, Desai D, Postonogova T, Siddiqui N. Accuracy of conventional digital palpation and ultrasound of the cricothyroid membrane in obese women in labour. Anaesthesia 2015
  8. 1230–4. [CrossRef ] 7. Siddiqui N, Arzola C, Friedman Z, Guerina L, You-Ten KE. Ultra sound Improves Cricothyrotomy Success in Cadavers with Poorly Defined Neck Anatomy: A Randomized Control Trial. Anesthesiology 2015
  9. 1033–41. [CrossRef ] 8. Curtis K, Ahern M, Dawson M, Mallin M. Ultrasound-guided, Bougieassisted cricothyroidotomy: a description of a novel technique in cadaveric models. Acad Emerg Med 2012
  10. 876–9. [CrossRef ] 9. Tsui B, Ip V, Walji A. Airway sonography in live models and cadavers. J Ultrasound Med 2013
  11. 1049–58. [CrossRef ] 10. Nutbeam T, Clarke R, Luff T, Enki D, Gay D. The height of the cricothyroid membrane on computed tomography scans in trauma patients. Anaesthesia 2017
  12. 987–92. [CrossRef ] 11. Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J 1985
  13. 429–34. [CrossRef ] 12. Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia 1984
  14. 1105–11. [CrossRef ] 13. How can I decide the sample size for a study of agreement between two methods of measurement? Available at: https://www-users.york.ac.uk/ ~mb55/meas/sizemeth.htm. Accessed July 2, 2019. 14. Nicholls SE, Sweeney TW, Ferre RM, Strout TD. Bedside so