To evaluate the accuracy of ultrasound in verifying endotracheal tube (ETT) position in neonates.

Sixty neonates of both sexes, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , aged 2-28 days, weighing 2.5-4.8 kg, scheduled for urachal fistula/urachal resection or inguinal hernia repair under general anesthesia, were divided into 2 groups (n=30 each) using a random number table method: auscultation group and ultrasound group.Confirmation of ETT position was performed in two stages.In the first stage, misplacement of ETT into esophagus was identified using auscultation and ultrasound techniques after intubation, and end-tidal carbon dioxide pressure was considered as the gold standard for identification of esophageal intubation.In the second stage, misplacement of ETT into bronchus was identified using auscultation and ultrasound after confirming ETT position was within the trachea, and electronic bronchoscope served as the gold standard for identification of bronchial intubation.

Compared with auscultation group, the accurate rate of identification of bronchial intubation was significantly increased in ultrasound group (P<0.05). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of auscultation for identification of esophageal intubation was 100%, 96.3%, 75% and 100%, respectively.The sensitivity, specificity, PPV and NPV of auscultation for identification of bronchial intubation was 33.3%, 95.8%, 66.7% and 85.2%, respectively.The sensitivity, specificity, PPV and NPV of ultrasound for identification of esophageal or bronchial intubation were all 100%.

Ultrasound can verify ETT position accurately in neonates.

Ultrasonography; Intubation, intratracheal; Infant, newborn