Screening Performance Characteristics of Ultrasonogra-phy in Confirmation of Endotracheal Intubation; a Systematic Review and Meta-analysis

Recent studies have suggested that point-of-care ultrasonography can be used for confirming theplacement of endotracheal tube. This systematic review and meta-analysis aimed to investigate the sensitivityand specificity of ultrasonography for confirming endotracheal tube placement.

In this meta-analysis,systematic search of the previous published papers investigating the diagnostic accuracy of ultrasonography forconfirmation of endotracheal tube placement was performed. Seven electronic databases, including PubMed,Scopus, Google Scholar, EBSCO, EMBASE, Web of Science, and Cochrane Database were searched up to July2021, for all relevant articles published in English on this topic. Meta-DiSc version 1.4 software was used for sta-tistical analysis.

The estimated pooled sensitivity and specificity of ultrasonography for confirmation ofendotracheal tube location were 0.98 (95% CI: 0.98–0.99) and 0.94 (95% CI 0.91–0.96), respectively. The pooledpositive likelihood ratio and negative likelihood ratio were 5.94 (95% CI 4.41–7.98) and 0.03 (95% CI: 0.02-0.04),respectively. The diagnostic odds ratio of ultrasonography was 281.47 and the area under hierarchical summaryreceiver operating characteristic (HSROC) revealed an appropriate accuracy of 0.98.

Ultrasonog-raphy has high diagnostic accuracy and can be used as a promising tool for confirmation of endotracheal tubeplacement, especially in critically ill patients or when capnography is not available, or its result is equivocal.