Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica

Antecedentes: La inserción y adecuado posicionamiento del TOT en la población pediátrica, no se ha definido en su totalidad. La radiografía de tórax, el TAC, la resonancia y la fibrobroncoscopia, se consideran el GOLD STANDARD. Existen fórmulas adecuadas a edad, peso y talla, sin que ninguna sea alt...

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Autores:
Rodríguez Olarte, Diana Carolina
Vergel Mantilla, Sergio
Tipo de recurso:
Fecha de publicación:
2022
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/16903
Acceso en línea:
http://hdl.handle.net/20.500.12749/16903
Palabra clave:
Anesthesiology
Medical sciences
Health sciences
Medicine
Airway management
Intratracheal intubation
Ultrasonography
Pediatrics
Ultrasound
Intensive care unit
Imaging systems in medicine
Diagnostic imaging
Anestesiología
Ciencias médicas
Medicina
Ecografía
Unidad de cuidados intensivos
Sistemas de imágenes en medicina
Diagnóstico por imágenes
Ciencias de la salud
Manejo de la vía aérea
Intubación intratraqueal
Ultrasonografía
Pediatría
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oai_identifier_str oai:repository.unab.edu.co:20.500.12749/16903
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica
dc.title.translated.spa.fl_str_mv Ultrasound assessment of endotracheal tube positioning in the pediatric population
title Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica
spellingShingle Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica
Anesthesiology
Medical sciences
Health sciences
Medicine
Airway management
Intratracheal intubation
Ultrasonography
Pediatrics
Ultrasound
Intensive care unit
Imaging systems in medicine
Diagnostic imaging
Anestesiología
Ciencias médicas
Medicina
Ecografía
Unidad de cuidados intensivos
Sistemas de imágenes en medicina
Diagnóstico por imágenes
Ciencias de la salud
Manejo de la vía aérea
Intubación intratraqueal
Ultrasonografía
Pediatría
title_short Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica
title_full Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica
title_fullStr Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica
title_full_unstemmed Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica
title_sort Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica
dc.creator.fl_str_mv Rodríguez Olarte, Diana Carolina
Vergel Mantilla, Sergio
dc.contributor.advisor.none.fl_str_mv Meléndez Flórez, Héctor Julio
dc.contributor.author.none.fl_str_mv Rodríguez Olarte, Diana Carolina
Vergel Mantilla, Sergio
dc.contributor.cvlac.spa.fl_str_mv Meléndez Flórez, Héctor Julio [0000320609]
dc.contributor.orcid.spa.fl_str_mv Meléndez Flórez, Héctor Julio [0000-0003-1791-8099]
dc.subject.keywords.spa.fl_str_mv Anesthesiology
Medical sciences
Health sciences
Medicine
Airway management
Intratracheal intubation
Ultrasonography
Pediatrics
Ultrasound
Intensive care unit
Imaging systems in medicine
Diagnostic imaging
topic Anesthesiology
Medical sciences
Health sciences
Medicine
Airway management
Intratracheal intubation
Ultrasonography
Pediatrics
Ultrasound
Intensive care unit
Imaging systems in medicine
Diagnostic imaging
Anestesiología
Ciencias médicas
Medicina
Ecografía
Unidad de cuidados intensivos
Sistemas de imágenes en medicina
Diagnóstico por imágenes
Ciencias de la salud
Manejo de la vía aérea
Intubación intratraqueal
Ultrasonografía
Pediatría
dc.subject.lemb.spa.fl_str_mv Anestesiología
Ciencias médicas
Medicina
Ecografía
Unidad de cuidados intensivos
Sistemas de imágenes en medicina
Diagnóstico por imágenes
dc.subject.proposal.spa.fl_str_mv Ciencias de la salud
Manejo de la vía aérea
Intubación intratraqueal
Ultrasonografía
Pediatría
description Antecedentes: La inserción y adecuado posicionamiento del TOT en la población pediátrica, no se ha definido en su totalidad. La radiografía de tórax, el TAC, la resonancia y la fibrobroncoscopia, se consideran el GOLD STANDARD. Existen fórmulas adecuadas a edad, peso y talla, sin que ninguna sea altamente sensible ni específica. De manera rutinaria no se cuenta con una herramienta diagnóstica que permita de forma fiel abarcar todos estos aspectos. Actualmente el uso de la ecografía como equipo de monitoreo y de procedimientos por el Anestesiólogo, nos permite evaluar la vía aérea y el posicionamiento del TOT, evaluar signos de ventilación bipulmonar, como se describe el signo de deslizamiento pulmonar o “lung sliding” descartando así su ubicación monobronquial y esofágica. El nivel de recomendación de este equipo como diagnóstico aún no está definido. Objetivo: Describir el adecuado posicionamiento del tubo endotraqueal, mediante ultrasonografía en pacientes que requieren soporte ventilatorio hospitalizados en la unidad de cuidados intensivos (UCI) pediátricos y neonatales. Materiales y métodos: Estudio analítico de tipo corte transversal: Evaluación de dispositivos médicos (estudio de tecnologías diagnósticas: Ultrasonografía) que incluyó 65 pacientes de población ingresados en la UCI pediátrica y neonatal.
publishDate 2022
dc.date.accessioned.none.fl_str_mv 2022-07-11T20:48:55Z
dc.date.available.none.fl_str_mv 2022-07-11T20:48:55Z
dc.date.issued.none.fl_str_mv 2022
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv Tesis
dc.type.hasversion.none.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.redcol.none.fl_str_mv http://purl.org/redcol/resource_type/TM
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/16903
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unab.edu.co
url http://hdl.handle.net/20.500.12749/16903
identifier_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
dc.language.iso.spa.fl_str_mv spa
language spa
dc.relation.references.spa.fl_str_mv 1. Sawyer T, Foglia E, Hatch LD, Moussa A, Ades A, Johnston L, et al. Improving neonatal intubation safety: A journey of a thousand miles. J Neonatal Perinatal Med. 2017;10(2):125–31
2. Kristensen MS. Ultrasonography in the management of the airway. Acta Anaesthesiol Scand. 2011;55(10):1155–73.
3. Chou EH, Dickman E, Tsou PY, Tessaro M, Tsai YM, Ma MHM, et al. Ultrasonography for confirmation of endotracheal tube placement: A systematic review and meta-analysis. Resuscitation [Internet]. 2015;90:97– 103. Available from: http://dx.doi.org/10.1016/j.resuscitation.2015.02.013
4. Volsko TA, McNinch NL, Prough DS, Bigham MT. Adherence to Endotracheal Tube Depth Guidelines and Incidence of Malposition in Infants and Children. Respir Care. 2018;63(9):1111–7.
5. Chowdhry R, Dangman B, Pinheiro JMB. The concordance of ultrasound technique versus X-ray to confirm endotracheal tube position in neonates. J Perinatol [Internet]. 2015;35(7):481–4. Available from: http://dx.doi.org/10.1038/jp.2014.240
6. Lau N, Playfor SD, Rashid A, Dhanarass M. New formulae for predicting tracheal tube length. Paediatr Anaesth. 2006;16(12):1238–43
7. Ramsingh D, Frank E, Haughton R, Schilling J, Gimenez K, Banh E, et al. Auscultation versus point-of-care ultrasound to determine endotracheal versus bronchial intubation. Anesthesiology [Internet]. 2016;124(5):1012–20. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export& id=L608901430%0Ahttp://dx.doi.org/10.1097/ALN.0000000000001073
8. Foglia EE, Ades A, Napolitano N, Leffelman J, Nadkarni V, Nishisaki A. Factors Associated with Adverse Events during Tracheal Intubation in the NICU. Neonatology. 2015;108(1):23–9.
9. Harris EA, Arheart KL, Penning DH. Endotracheal tube malposition within the pediatric population: a common event despite clinical evidence of correct placement. Can J Anesth. 2008;55(10):685–90.
10. Sitzwohl C, Langheinrich A, Schober A, Krafft P, Sessler DI, Herkner H, et al. Endobronchial intubation detected by insertion depth of endotracheal tube, bilateral auscultation, or observation of chest movements: Randomised trial. BMJ. 2010;341(7783):1143
11. De Caen AR, Berg MD, Chameides L, Gooden CK, Hickey RW, Scott HF, et al. Part 12: Pediatric advanced life support: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18):S526–42
12. Schmölzer G, Roehr C. Techniques to ascertain correct endotracheal tube placement in neonates. Cochrane Database Syst Rev [Internet]. 2014;(9):N.PAG-N.PAG. Available from: http://oxfordbrookes.idm.oclc.org/login?url=http://search.ebscohost.com/login .aspx?direct=true&db=cin20&AN=107769206&site=ehost-live
13. Koshy T, Misra S, Chatterjee N, Dharan BS. Accuracy of a Chest X-Ray– Based Method for Predicting the Depth of Insertion of Endotracheal Tubes in Pediatric Patients Undergoing Cardiac Surgery. J Cardiothorac Vasc Anesth [Internet]. 2016;30(4):947–53. Available from: http://dx.doi.org/10.1053/j.jvca.2016.01.031
14. Chung HW, Lee W Te, Chen HL. Reexamining the ideal depth of endotracheal tube in neonates. Pediatr Neonatol [Internet]. 2018;59(3):258–62. Available from: https://doi.org/10.1016/j.pedneo.2017.10.001
15. Schmölzer GM, O’Reilly M, Davis PG, Cheung PY, Roehr CC. Confirmation of correct tracheal tube placement in newborn infants. Resuscitation [Internet]. 2013;84(6):731–7. Available from: http://dx.doi.org/10.1016/j.resuscitation.2012.11.028
16. Todres D, DeBros F, Kramer SS, Moylan FMB, Shannon DC. Endotracheal tube displacement in the newborn infant. J Pediatr [Internet]. 1976 Jul 1 [cited 2020 Jun 20];89(1):126–7. Available from: https://www.jpeds.com/article/S0022-3476(76)80946-8/pdf
17. Sugiyama K, Yokoyama K. Displacement of the Endotacheal Tube Caused by Change of Head Position in Pediatric Anesthesia: Evaluation by Fiberoptic Bronchoscopy. Anesth Analg. 1996;82:251–3
18. Kim KO, Um WS, Kim CS. Comparative evaluation of methods for ensuring the correct position of the tracheal tube in children undergoing open heart surgery*. Anaesthesia [Internet]. 2003 Sep 1 [cited 2020 Jun 18];58(9):889– 93. Available from: http://doi.wiley.com/10.1046/j.1365-2044.2003.03336.x
19. Weiss M, Knirsch W, Kretschmar O, Dullenkopf A, Tomaske M, Balmer C, et al. Tracheal tube-tip displacement in children during head-neck movement - A radiological assessment. Br J Anaesth. 2006;96(4):486–91.
20. Marraro G. Airway Management. In: Marraro G, editor. Pediatric Anesthesia Basic Principles—State of the Art—Future. Toronto: People’s Medical Publishing House-USA; 2011. p. 1167–85
21. Sharma D, Tabatabaii SA, Farahbakhsh N. Role of ultrasound in confirmation of endotracheal tube in neonates : a review. J Matern Neonatal Med [Internet]. 2019;32(8):1359–67. Available from: https://doi.org/10.1080/14767058.2017.1403581
22. Neunhoeffer F, Wahl T, Hofbeck M, Renk H, Esslinger M, Hanelt M, et al. A new method for determining the insertion depth of tracheal tubes in children: A pilot study. Br J Anaesth. 2016;116(3):393–7
23. Pek JH, Tan EM, Hao Y, Ong GY. Comparison of Formulae for Orotracheal Intubation Depth in the Paediatric Population. Ann Acad Med Singapore. 2018;47(4):138–42.
24. Kempley ST, Moreiras JW, Petrone FL. Endotracheal tube length for neonatal intubation. Resuscitation. 2008;77(3):369–73
25. Bartle RMg, Miller AG, Diez AJ, Smith PB, A GM, Puia-Dumitrescu M. Evaluating Endotracheal Tube Depth in Infants Weighing Less Than 1 Kilogram. Respir Care. 2019;64(3):243–7.
26. Lee SU, Jung JY, Kim DK, Kwak YH, Kwon H, Cho JH, et al. New decision formulas for predicting endotracheal tube depth in children: analysis of neck CT images. Emerg Med J. 2018;35(5):303–8.
27. Fiadjoe JE, Litman RS, Serber JF, Stricker PA, Coté CJ. The Pediatric Airway [Internet]. Sixth Edit. A Practice of Anesthesia for Infants and Children. Elsevier Inc.; 2018. 297-339.e21 p. Available from: https://doi.org/10.1016/B978-0-323-42974-0.00014-8
28. Holzman RS. Airway Management. In: Holszman R, editor. Smith’s Anesthesia for Infants and Children [Internet]. Ninth Edit. Philadelphia: Elsevier Inc.; 2017. p. 349–69. Available from: http://dx.doi.org/10.1016/B9780-323-34125-7.00018-8
29. Boensch M, Schick V, Spelten O, Hinkelbein J. Estimation of the optimal tube length : Systematic review article on published formulae for infants and children. Anaesthesist. 2015;65(2):115–21
30. Manica D, de Souza Saleh Netto C, Schweiger C, Sekine L, Enéas LV, Pereira DR, et al. Association of endotracheal tube repositioning and acute laryngeal lesions during mechanical ventilation in children. Eur Arch Oto-RhinoLaryngology. 2017;274(7):2871–6.
31. Petrucci N, Iacovelli W. Ventilation with lower tidal volumes versus traditional tidal volumes in adults for acute lung injury and acute respiratory distress syndrome. Cochrane Database Syst Rev [Internet]. 2003 Jan 7 [cited 2020 Jun 22];(1):1–21. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003844/full
32. Rimensberger PC, Cheifetz IM, Jouvet P, Thomas NJ, Willson DF, Erickson S, et al. Ventilatory support in children with pediatric acute respiratory distress syndrome: Proceedings from the pediatric acute lung injury consensus conference. Pediatr Crit Care Med. 2015;16(5):S51–60
33. Orloff KE, Turner DA, Rehder KJ. The Current State of Pediatric Acute Respiratory Distress Syndrome. Pediatr Allergy Immunol Pulmonol [Internet]. 2019 Jun 1 [cited 2020 Jun 20];32(2):35–44. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6589490/pdf/ped.2019.0999.p df
34. Curley GF, Laffey JG, Zhang H, Slutsky AS, Laffey P. Biotrauma and Ventilator-Induced Lung Injury Clinical Implications. Chest [Internet]. 2016 Nov [cited 2020 Jun 22];150(5):1109–17. Available from: http://dx.doi.org/10.1016/j.chest.2016.07.019
35. Klingenberg C, Wheeler KI, Mccallion N, Morley CJ, Davis PG. Volumetargeted versus pressure-limited ventilation in neonates. Cochrane Database Syst Rev [Internet]. 2017 Oct 17 [cited 2020 Jun 22];2017(10):1–91. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003666.pub 4/epdf/full
36. Khemani RG, Conti D, Alonzo TA, Bart RD, Newth CJL, Khemani RG, et al. Effect of tidal volume in children with acute hypoxemic respiratory failure. Intensive Care Med [Internet]. 2009 Jun 17 [cited 2020 Jun 21];35:1428–37Available from: https://link.springer.com/content/pdf/10.1007/s00134-0091527-z.pdf
37. Chenkin J, McCartney CJL, Jelic T, Romano M, Heslop C, Bandiera G. Defining the learning curve of point-of-care ultrasound for confirming endotracheal tube placement by emergency physicians. Crit Ultrasound J. 2015;7(1):7–14
38. Kerrey BT, Geis GL, Quinn AM, Hornung RW, Ruddy RM. A Prospective Comparison of Diaphragmatic Ultrasound and Chest Radiography to Determine Endotracheal Tube Position in a Pediatric Emergency Department. Pediatrics [Internet]. 2009;123(6):e1039–44. Available from: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2008-2828
39. Alonso Quintela P, Oulego Erroz I, Mora Matilla M, Rodríguez Blanco S, Mata Zubillaga D, Regueras Santos L. Utilidad de la ecografía comparada con la capnografía y la radiografía en la intubación traqueal. An Pediatr [Internet]. 2014;81(5):283–8. Available from: http://dx.doi.org/10.1016/j.anpedi.2014.01.004
40. Das SK, Choupoo NS, Haldar R, Lahkar A. Transtracheal ultrasound for verification of endotracheal tube placement: a systematic review and metaanalysis. Can J Anesth Can d’anesthésie. 2015;62(4):413–23
41. Kajekar P, Mendonca C, Gaur V. Role of Ultrasound in Airway Assessment and Management. Int J Ultrasound Appl Technol Perioper Care [Internet]. 2010;(May 2010):97–100. Available from: http://www.jaypeejournals.com/eJournals/ShowText.aspx?ID=896&Type=FR EE&TYP=TOP&IN=_eJournals/International Journal of Ultrasound and Applied Technologies in Perioperative Care.jpg&IID=80&AID=14&Year=2010&isPDF=YES
42. Vijaykumar R, Saboo AR. Review of Different Methods Used for Confirmation of Endotracheal Tube Placement in Newborns. J Neonatal Biol. 2014;3(4):2–
43. Kristensen MS, Teoh WH, Rudolph SS. Ultrasonographic identification of the cricothyroid membrane: Best evidence, techniques, and clinical impact. Br J Anaesth. 2016;117(S1):i39–48
44. Fiadjoe JE, Stricker P, Gurnaney H, Nishisaki A, Rabinowitz A, Gurwitz A, et al. Ultrasound-guided Tracheal Intubation. Anesthesiology [Internet]. 2012;117(6):1389–91. Available from: http://anesthesiology.pubs.asahq.org/Article.aspx?doi=10.1097/ALN.0b013e 3182746a30
45. Galicinao J, Bush AJ, Godambe SA. Use of Bedside Ultrasonography for Endotracheal Tube Placement in Pediatric Patients: A Feasibility Study. Pediatrics [Internet]. 2007;120(6):1297–303. Available from: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2006-2959
46. Stafrace S, Engelhardt T, Teoh WH, Kristensen MS. Essential ultrasound techniques of the pediatric airway. Pediatr Anesth. 2016;26(2):122–31
47. Kristensen MS, Teoh WH, Graumann O, Laursen CB. Ultrasonography for clinical decision-making and intervention in airway management: From the mouth to the lungs and pleurae. Insights Imaging. 2014;5(2):253–79.
48. Daniel SJ, Bertolizio G, McHugh T. Airway ultrasound: point of care in children – the time is now. Pediatr Anesth. 2020;0(0):1–6.
49. Tessaro MO, Salant EP, Arroyo AC, Haines LE, Dickman E. Tracheal rapid ultrasound saline test (T.R.U.S.T.) for confirming correct endotracheal tube depth in children. Resuscitation [Internet]. 2015;89(C):8–12. Available from: http://dx.doi.org/10.1016/j.resuscitation.2014.08.033
50. Kerrey BT, Rinderknecht AS, Geis GL, Nigrovic LE, Mittiga MR. Rapid sequence intubation for pediatric emergency patients: Higher frequency of failed attempts and adverse effects found by video review. Ann Emerg Med [Internet]. 2012;60(3):251–9. Available from: http://dx.doi.org/10.1016/j.annemergmed.2012.02.013
51. Park SC, Ryu JH, Yeom SR, Jeong JW, Cho SJ. Confirmation of endotracheal intubation by combined ultrasonographic methods in the emergency department. EMA - Emerg Med Australas. 2009;21(4):293–7.
52. Marciniak B, Fayoux P, Hébrard A, Krivosic-Horber R, Engelhardt T, Bissonnette B. Airway management in children: Ultrasonography assessment of tracheal intubation in real time? Anesth Analg. 2009;108(2):461–5
53. Clifford M, Butt W. Tracheal tube insertion is an essential part of modern paediatric anaesthesia and critical care: Let us get it right. Br J Anaesth. 2016;116(5):582–4.
54. Lin MJ, Gurley K, Hoffmann B. Seeing Is Believing: Ultrasound in Pediatric Procedural Performance: A Systematic Review∗. Pediatr Crit Care Med. 2016;17(10):e469–76
55. Abbasi S, Farsi D, Zare MA, Hajimohammadi M, Rezai M, Hafezimoghadam P. Direct ultrasound methods: A confirmatory technique for proper endotracheal intubation in the emergency department. Eur J Emerg Med. 2015;22(1):10–6.
56. Ahn JH, Kwon E, Lee SY, Hahm TS, Jeong JS. Ultrasound-guided lung sliding sign to confirm optimal depth of tracheal tube insertion in young children. Br J Anaesth [Internet]. 2019;123(3):309–15. Available from: https://doi.org/10.1016/j.bja.2019.03.020
57. Kundra P, Mishra SK, Ramesh A. Ultrasound of the airway. Indian J Anaesth. 2011;55(5):456–62
58. Verghese ST, Hannallah RS, Slack MC, Cross RR, Patel KM. Auscultation of bilateral breath sounds does not rule out endobronchial intubation in children. Anesth Analg. 2004;99(1):56–8
59. Canadian point of care ultrasound society. Protección y desinfección de ecógrafos de carro durante la pandemia por COVID-19 [Internet]. Disinfection protocols for ultrasound machines during COVID-19 management. 2020 [cited 2020 Jun 17]. p. 1–2. Available from: https://www.cpocus.ca/covid19/disinfecting-protocols/
60. Ministerio de Salud y Protección Social. Limpieza y Desinfección en Servicios de Salud ante la introducción del nuevo coronavirus (SARS-CoV-2) a Colombia [Internet]. Bogotá, Colombia; 2020 Mar [cited 2020 Jun 17]. Available from: https://www.minsalud.gov.co/Ministerio/Institucional/Procesos y procedimientos/GIPS07.pdf
61. Jaeel, P., Sheth, M. & Nguyen, J. Ultrasonography for endotracheal tube position in infants and children. Eur J Pediatr 176, 293–300 (2017). https://doi.org/10.1007/s00431-017-2848-5
62. Lin, Margaret J. MD1; Gurley, Kiersten MD2; Hoffmann, Beatrice MD, PhD, RDMS2 Bedside Ultrasound for Tracheal Tube Verification in Pediatric Emergency Department and ICU Patients: A Systematic Review*, Pediatric Critical Care Medicine: October 2016 - Volume 17 - Issue 10 - p e469-e476 doi: 10.1097/PCC.0000000000000907
63. Gottlieb M, Holladay D, Burns KM, Nakitende D, Bailitz J. Ultrasound for airway management: An evidence-based review for the emergency clinician. Am J Emerg Med. 2020 May;38(5):1007-1013. doi: 10.1016/j.ajem.2019.12.019. Epub 2019 Dec 11. PMID: 31843325
64. Felipe Cardemil. Análisis de comparación y aplicaciones del método de Bland-Altman: ¿concordancia o correlación? Medwave 2017 Ene-Feb;16(1):e6852 doi:10.5867/medwave.2017.01.6852
65. Harris, E. A., Arheart, K. L., & Penning, D. H. (2008). Endotracheal tuve malposition within the pediatric population: a common event despite clinical evidence of correct placement. Canadian Journal of Anesthesia/Journal Canadien D’anesthésie, 55(10), 685–690.doi:10.1007/bf03017744
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spelling Meléndez Flórez, Héctor Julio20cc143a-86c7-44c4-bcab-57fb40719b36Rodríguez Olarte, Diana Carolinabd3a4723-98bd-4ff4-97bd-f99467b67476Vergel Mantilla, Sergiofe54400f-fe3d-4cc7-beb9-20cc338457c4Meléndez Flórez, Héctor Julio [0000320609]Meléndez Flórez, Héctor Julio [0000-0003-1791-8099]Floridablanca (Santander, Colombia)UNAB Campus Bucaramanga2022-07-11T20:48:55Z2022-07-11T20:48:55Z2022http://hdl.handle.net/20.500.12749/16903instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coAntecedentes: La inserción y adecuado posicionamiento del TOT en la población pediátrica, no se ha definido en su totalidad. La radiografía de tórax, el TAC, la resonancia y la fibrobroncoscopia, se consideran el GOLD STANDARD. Existen fórmulas adecuadas a edad, peso y talla, sin que ninguna sea altamente sensible ni específica. De manera rutinaria no se cuenta con una herramienta diagnóstica que permita de forma fiel abarcar todos estos aspectos. Actualmente el uso de la ecografía como equipo de monitoreo y de procedimientos por el Anestesiólogo, nos permite evaluar la vía aérea y el posicionamiento del TOT, evaluar signos de ventilación bipulmonar, como se describe el signo de deslizamiento pulmonar o “lung sliding” descartando así su ubicación monobronquial y esofágica. El nivel de recomendación de este equipo como diagnóstico aún no está definido. Objetivo: Describir el adecuado posicionamiento del tubo endotraqueal, mediante ultrasonografía en pacientes que requieren soporte ventilatorio hospitalizados en la unidad de cuidados intensivos (UCI) pediátricos y neonatales. Materiales y métodos: Estudio analítico de tipo corte transversal: Evaluación de dispositivos médicos (estudio de tecnologías diagnósticas: Ultrasonografía) que incluyó 65 pacientes de población ingresados en la UCI pediátrica y neonatal.RESUMEN: 5 1. INTRODUCCION 7 2. PLANTEAMIENTO DEL PROBLEMA 8 2.1 Pregunta de investigación 9 2.2 Hipótesis investigativa 9 2.3 Justificación 9 3. MARCO TEÓRICO 12 4. OBJETIVOS 32 4.1 Objetivo general 32 4.2 Objetivos específicos 32 5. METODOLOGÍA 33 5.1 Tipo de estudio 33 5.2 Diseño Muestral 33 5.3 Población Elegible 33 5.4 Criterios de selección 34 5.4.1 Criterios de inclusión: 34 5.4.2 Criterios de exclusión: 34 6. VARIABLES DEL ESTUDIO 35 6.1 Variable Resultado (Ver anexo 1). 35 6.2 Variables Independientes: 36 7. MEDIDAS DE BIOSEGURIDAD. 39 8. RECOLECCIÓN DE LA INFORMACIÓN Y MANEJO DE LOS DATOS 41 9. CONSIDERACIONES ÉTICAS 44 10. ANÁLISIS DE LOS DATOS 46 11. RESULTADOS 47 11.1 Características generales de la población 48 11.2 Datos de intubación orotraqueal 49 11.3 Causas de intubación orotraqueal 50 11.4 Verificación de correcta ubicación del tubo orotraqueal. 51 11.4.1 Valoración radiológica del posicionamiento del tubo orotraqueal. 51 11.4.1 Reposicionamiento del tubo endotraqueal 51 11.4.2 Valoración radiológica del posicionamiento del tubo orotraqueal. ¡Error! Marcador no definido. 11.4.3 Número de reacomodaciones según el personal que realiza el procedimiento. 51 11.4.4 Valoración ecográfica del posicionamiento del tubo orotraqueal 52 11.5. Rendimiento del examen ecográfico comparado con la radiografía de tórax. 53 11.6 Rendimiento de la Ecografía como prueba diagnóstica: 53 11.7 Correlación de posicionamiento del tubo endotraqueal según distancia a comisura labial encontrada y predicha. 54 11.9 Análisis de regresión y correlación entre predicho y observado 55 11. 8 Coeficientes de correlación 57 11.10 Concordancia entre predicho y observado 59 11.11 Factores asociados a mal posicionamiento del tubo endotraqueal. 62 12. DISCUSIÓN 64 13. CONCLUSIONES 68 14. IMPACTOS Y PRODUCTOS ESPERADOS 69 15.BIBLIOGRAFÍA 71 16. ANEXOS 81 16.1 Anexo 1 81 16.2 Anexo 2 83 16.3 Anexo 3 86 16.4 Anexo 4 91EspecializaciónBackground: The proper insertion and positioning of the TOT in the pediatric population has not been fully defined. Chest radiography, CT, MRI and fiberoptic bronchoscopy are considered the GOLD STANDARD. There are formulas suitable for age, weight and height, none of which are highly sensitive or specific. Routinely, there is no diagnostic tool that faithfully covers all these aspects. Currently, the use of ultrasound as a monitoring and procedural equipment by the Anesthesiologist allows us to evaluate the airway and the TOT position, evaluate signs of bipulmonary ventilation, as described in the lung slide sign or "lung slide" thus ruling out its monobronchial and esophageal location. The level of recommendation of this equipment as a diagnosis is not yet defined. Objetivo: To describe the proper positioning of the endotracheal tube by ultrasonography in patients requiring ventilatory support hospitalized in the pediatric and neonatal intensive care unit Materials y methods: Cross-sectional analytical study: Evaluation of medical devices (study of diagnostic technologies: Ultrasonography) that included 65 population patients admitted to the pediatric and neonatal ICU.Modalidad Presencialapplication/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátricaUltrasound assessment of endotracheal tube positioning in the pediatric populationEspecialista en AnestesiologíaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Anestesiologíainfo:eu-repo/semantics/masterThesisTesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/redcol/resource_type/TMAnesthesiologyMedical sciencesHealth sciencesMedicineAirway managementIntratracheal intubationUltrasonographyPediatricsUltrasoundIntensive care unitImaging systems in medicineDiagnostic imagingAnestesiologíaCiencias médicasMedicinaEcografíaUnidad de cuidados intensivosSistemas de imágenes en medicinaDiagnóstico por imágenesCiencias de la saludManejo de la vía aéreaIntubación intratraquealUltrasonografíaPediatría1. Sawyer T, Foglia E, Hatch LD, Moussa A, Ades A, Johnston L, et al. Improving neonatal intubation safety: A journey of a thousand miles. J Neonatal Perinatal Med. 2017;10(2):125–312. Kristensen MS. Ultrasonography in the management of the airway. Acta Anaesthesiol Scand. 2011;55(10):1155–73.3. Chou EH, Dickman E, Tsou PY, Tessaro M, Tsai YM, Ma MHM, et al. Ultrasonography for confirmation of endotracheal tube placement: A systematic review and meta-analysis. Resuscitation [Internet]. 2015;90:97– 103. Available from: http://dx.doi.org/10.1016/j.resuscitation.2015.02.0134. Volsko TA, McNinch NL, Prough DS, Bigham MT. Adherence to Endotracheal Tube Depth Guidelines and Incidence of Malposition in Infants and Children. Respir Care. 2018;63(9):1111–7.5. Chowdhry R, Dangman B, Pinheiro JMB. The concordance of ultrasound technique versus X-ray to confirm endotracheal tube position in neonates. J Perinatol [Internet]. 2015;35(7):481–4. Available from: http://dx.doi.org/10.1038/jp.2014.2406. Lau N, Playfor SD, Rashid A, Dhanarass M. New formulae for predicting tracheal tube length. Paediatr Anaesth. 2006;16(12):1238–437. Ramsingh D, Frank E, Haughton R, Schilling J, Gimenez K, Banh E, et al. Auscultation versus point-of-care ultrasound to determine endotracheal versus bronchial intubation. Anesthesiology [Internet]. 2016;124(5):1012–20. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export& id=L608901430%0Ahttp://dx.doi.org/10.1097/ALN.00000000000010738. Foglia EE, Ades A, Napolitano N, Leffelman J, Nadkarni V, Nishisaki A. Factors Associated with Adverse Events during Tracheal Intubation in the NICU. Neonatology. 2015;108(1):23–9.9. Harris EA, Arheart KL, Penning DH. Endotracheal tube malposition within the pediatric population: a common event despite clinical evidence of correct placement. Can J Anesth. 2008;55(10):685–90.10. Sitzwohl C, Langheinrich A, Schober A, Krafft P, Sessler DI, Herkner H, et al. Endobronchial intubation detected by insertion depth of endotracheal tube, bilateral auscultation, or observation of chest movements: Randomised trial. BMJ. 2010;341(7783):114311. De Caen AR, Berg MD, Chameides L, Gooden CK, Hickey RW, Scott HF, et al. Part 12: Pediatric advanced life support: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18):S526–4212. Schmölzer G, Roehr C. Techniques to ascertain correct endotracheal tube placement in neonates. Cochrane Database Syst Rev [Internet]. 2014;(9):N.PAG-N.PAG. Available from: http://oxfordbrookes.idm.oclc.org/login?url=http://search.ebscohost.com/login .aspx?direct=true&db=cin20&AN=107769206&site=ehost-live13. Koshy T, Misra S, Chatterjee N, Dharan BS. Accuracy of a Chest X-Ray– Based Method for Predicting the Depth of Insertion of Endotracheal Tubes in Pediatric Patients Undergoing Cardiac Surgery. J Cardiothorac Vasc Anesth [Internet]. 2016;30(4):947–53. Available from: http://dx.doi.org/10.1053/j.jvca.2016.01.03114. Chung HW, Lee W Te, Chen HL. Reexamining the ideal depth of endotracheal tube in neonates. Pediatr Neonatol [Internet]. 2018;59(3):258–62. Available from: https://doi.org/10.1016/j.pedneo.2017.10.00115. Schmölzer GM, O’Reilly M, Davis PG, Cheung PY, Roehr CC. Confirmation of correct tracheal tube placement in newborn infants. Resuscitation [Internet]. 2013;84(6):731–7. Available from: http://dx.doi.org/10.1016/j.resuscitation.2012.11.02816. Todres D, DeBros F, Kramer SS, Moylan FMB, Shannon DC. Endotracheal tube displacement in the newborn infant. J Pediatr [Internet]. 1976 Jul 1 [cited 2020 Jun 20];89(1):126–7. Available from: https://www.jpeds.com/article/S0022-3476(76)80946-8/pdf17. Sugiyama K, Yokoyama K. Displacement of the Endotacheal Tube Caused by Change of Head Position in Pediatric Anesthesia: Evaluation by Fiberoptic Bronchoscopy. Anesth Analg. 1996;82:251–318. Kim KO, Um WS, Kim CS. Comparative evaluation of methods for ensuring the correct position of the tracheal tube in children undergoing open heart surgery*. Anaesthesia [Internet]. 2003 Sep 1 [cited 2020 Jun 18];58(9):889– 93. Available from: http://doi.wiley.com/10.1046/j.1365-2044.2003.03336.x19. Weiss M, Knirsch W, Kretschmar O, Dullenkopf A, Tomaske M, Balmer C, et al. Tracheal tube-tip displacement in children during head-neck movement - A radiological assessment. Br J Anaesth. 2006;96(4):486–91.20. Marraro G. Airway Management. In: Marraro G, editor. Pediatric Anesthesia Basic Principles—State of the Art—Future. Toronto: People’s Medical Publishing House-USA; 2011. p. 1167–8521. Sharma D, Tabatabaii SA, Farahbakhsh N. Role of ultrasound in confirmation of endotracheal tube in neonates : a review. J Matern Neonatal Med [Internet]. 2019;32(8):1359–67. Available from: https://doi.org/10.1080/14767058.2017.140358122. Neunhoeffer F, Wahl T, Hofbeck M, Renk H, Esslinger M, Hanelt M, et al. A new method for determining the insertion depth of tracheal tubes in children: A pilot study. Br J Anaesth. 2016;116(3):393–723. Pek JH, Tan EM, Hao Y, Ong GY. Comparison of Formulae for Orotracheal Intubation Depth in the Paediatric Population. Ann Acad Med Singapore. 2018;47(4):138–42.24. Kempley ST, Moreiras JW, Petrone FL. Endotracheal tube length for neonatal intubation. Resuscitation. 2008;77(3):369–7325. Bartle RMg, Miller AG, Diez AJ, Smith PB, A GM, Puia-Dumitrescu M. Evaluating Endotracheal Tube Depth in Infants Weighing Less Than 1 Kilogram. Respir Care. 2019;64(3):243–7.26. Lee SU, Jung JY, Kim DK, Kwak YH, Kwon H, Cho JH, et al. New decision formulas for predicting endotracheal tube depth in children: analysis of neck CT images. Emerg Med J. 2018;35(5):303–8.27. Fiadjoe JE, Litman RS, Serber JF, Stricker PA, Coté CJ. The Pediatric Airway [Internet]. Sixth Edit. A Practice of Anesthesia for Infants and Children. Elsevier Inc.; 2018. 297-339.e21 p. Available from: https://doi.org/10.1016/B978-0-323-42974-0.00014-828. Holzman RS. Airway Management. In: Holszman R, editor. Smith’s Anesthesia for Infants and Children [Internet]. Ninth Edit. Philadelphia: Elsevier Inc.; 2017. p. 349–69. Available from: http://dx.doi.org/10.1016/B9780-323-34125-7.00018-829. Boensch M, Schick V, Spelten O, Hinkelbein J. Estimation of the optimal tube length : Systematic review article on published formulae for infants and children. Anaesthesist. 2015;65(2):115–2130. Manica D, de Souza Saleh Netto C, Schweiger C, Sekine L, Enéas LV, Pereira DR, et al. Association of endotracheal tube repositioning and acute laryngeal lesions during mechanical ventilation in children. Eur Arch Oto-RhinoLaryngology. 2017;274(7):2871–6.31. Petrucci N, Iacovelli W. Ventilation with lower tidal volumes versus traditional tidal volumes in adults for acute lung injury and acute respiratory distress syndrome. Cochrane Database Syst Rev [Internet]. 2003 Jan 7 [cited 2020 Jun 22];(1):1–21. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003844/full32. Rimensberger PC, Cheifetz IM, Jouvet P, Thomas NJ, Willson DF, Erickson S, et al. Ventilatory support in children with pediatric acute respiratory distress syndrome: Proceedings from the pediatric acute lung injury consensus conference. Pediatr Crit Care Med. 2015;16(5):S51–6033. Orloff KE, Turner DA, Rehder KJ. The Current State of Pediatric Acute Respiratory Distress Syndrome. Pediatr Allergy Immunol Pulmonol [Internet]. 2019 Jun 1 [cited 2020 Jun 20];32(2):35–44. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6589490/pdf/ped.2019.0999.p df34. Curley GF, Laffey JG, Zhang H, Slutsky AS, Laffey P. Biotrauma and Ventilator-Induced Lung Injury Clinical Implications. Chest [Internet]. 2016 Nov [cited 2020 Jun 22];150(5):1109–17. Available from: http://dx.doi.org/10.1016/j.chest.2016.07.01935. Klingenberg C, Wheeler KI, Mccallion N, Morley CJ, Davis PG. Volumetargeted versus pressure-limited ventilation in neonates. Cochrane Database Syst Rev [Internet]. 2017 Oct 17 [cited 2020 Jun 22];2017(10):1–91. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003666.pub 4/epdf/full36. Khemani RG, Conti D, Alonzo TA, Bart RD, Newth CJL, Khemani RG, et al. Effect of tidal volume in children with acute hypoxemic respiratory failure. Intensive Care Med [Internet]. 2009 Jun 17 [cited 2020 Jun 21];35:1428–37Available from: https://link.springer.com/content/pdf/10.1007/s00134-0091527-z.pdf37. Chenkin J, McCartney CJL, Jelic T, Romano M, Heslop C, Bandiera G. Defining the learning curve of point-of-care ultrasound for confirming endotracheal tube placement by emergency physicians. Crit Ultrasound J. 2015;7(1):7–1438. Kerrey BT, Geis GL, Quinn AM, Hornung RW, Ruddy RM. A Prospective Comparison of Diaphragmatic Ultrasound and Chest Radiography to Determine Endotracheal Tube Position in a Pediatric Emergency Department. Pediatrics [Internet]. 2009;123(6):e1039–44. Available from: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2008-282839. Alonso Quintela P, Oulego Erroz I, Mora Matilla M, Rodríguez Blanco S, Mata Zubillaga D, Regueras Santos L. Utilidad de la ecografía comparada con la capnografía y la radiografía en la intubación traqueal. An Pediatr [Internet]. 2014;81(5):283–8. Available from: http://dx.doi.org/10.1016/j.anpedi.2014.01.00440. Das SK, Choupoo NS, Haldar R, Lahkar A. Transtracheal ultrasound for verification of endotracheal tube placement: a systematic review and metaanalysis. Can J Anesth Can d’anesthésie. 2015;62(4):413–2341. Kajekar P, Mendonca C, Gaur V. Role of Ultrasound in Airway Assessment and Management. Int J Ultrasound Appl Technol Perioper Care [Internet]. 2010;(May 2010):97–100. Available from: http://www.jaypeejournals.com/eJournals/ShowText.aspx?ID=896&Type=FR EE&TYP=TOP&IN=_eJournals/International Journal of Ultrasound and Applied Technologies in Perioperative Care.jpg&IID=80&AID=14&Year=2010&isPDF=YES42. Vijaykumar R, Saboo AR. Review of Different Methods Used for Confirmation of Endotracheal Tube Placement in Newborns. J Neonatal Biol. 2014;3(4):2–43. Kristensen MS, Teoh WH, Rudolph SS. Ultrasonographic identification of the cricothyroid membrane: Best evidence, techniques, and clinical impact. Br J Anaesth. 2016;117(S1):i39–4844. Fiadjoe JE, Stricker P, Gurnaney H, Nishisaki A, Rabinowitz A, Gurwitz A, et al. Ultrasound-guided Tracheal Intubation. Anesthesiology [Internet]. 2012;117(6):1389–91. Available from: http://anesthesiology.pubs.asahq.org/Article.aspx?doi=10.1097/ALN.0b013e 3182746a3045. Galicinao J, Bush AJ, Godambe SA. Use of Bedside Ultrasonography for Endotracheal Tube Placement in Pediatric Patients: A Feasibility Study. Pediatrics [Internet]. 2007;120(6):1297–303. Available from: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2006-295946. Stafrace S, Engelhardt T, Teoh WH, Kristensen MS. Essential ultrasound techniques of the pediatric airway. Pediatr Anesth. 2016;26(2):122–3147. Kristensen MS, Teoh WH, Graumann O, Laursen CB. Ultrasonography for clinical decision-making and intervention in airway management: From the mouth to the lungs and pleurae. Insights Imaging. 2014;5(2):253–79.48. Daniel SJ, Bertolizio G, McHugh T. Airway ultrasound: point of care in children – the time is now. Pediatr Anesth. 2020;0(0):1–6.49. Tessaro MO, Salant EP, Arroyo AC, Haines LE, Dickman E. Tracheal rapid ultrasound saline test (T.R.U.S.T.) for confirming correct endotracheal tube depth in children. Resuscitation [Internet]. 2015;89(C):8–12. Available from: http://dx.doi.org/10.1016/j.resuscitation.2014.08.03350. Kerrey BT, Rinderknecht AS, Geis GL, Nigrovic LE, Mittiga MR. Rapid sequence intubation for pediatric emergency patients: Higher frequency of failed attempts and adverse effects found by video review. Ann Emerg Med [Internet]. 2012;60(3):251–9. Available from: http://dx.doi.org/10.1016/j.annemergmed.2012.02.01351. Park SC, Ryu JH, Yeom SR, Jeong JW, Cho SJ. Confirmation of endotracheal intubation by combined ultrasonographic methods in the emergency department. EMA - Emerg Med Australas. 2009;21(4):293–7.52. Marciniak B, Fayoux P, Hébrard A, Krivosic-Horber R, Engelhardt T, Bissonnette B. Airway management in children: Ultrasonography assessment of tracheal intubation in real time? Anesth Analg. 2009;108(2):461–553. Clifford M, Butt W. Tracheal tube insertion is an essential part of modern paediatric anaesthesia and critical care: Let us get it right. Br J Anaesth. 2016;116(5):582–4.54. Lin MJ, Gurley K, Hoffmann B. Seeing Is Believing: Ultrasound in Pediatric Procedural Performance: A Systematic Review∗. Pediatr Crit Care Med. 2016;17(10):e469–7655. Abbasi S, Farsi D, Zare MA, Hajimohammadi M, Rezai M, Hafezimoghadam P. Direct ultrasound methods: A confirmatory technique for proper endotracheal intubation in the emergency department. Eur J Emerg Med. 2015;22(1):10–6.56. Ahn JH, Kwon E, Lee SY, Hahm TS, Jeong JS. Ultrasound-guided lung sliding sign to confirm optimal depth of tracheal tube insertion in young children. Br J Anaesth [Internet]. 2019;123(3):309–15. Available from: https://doi.org/10.1016/j.bja.2019.03.02057. Kundra P, Mishra SK, Ramesh A. Ultrasound of the airway. Indian J Anaesth. 2011;55(5):456–6258. Verghese ST, Hannallah RS, Slack MC, Cross RR, Patel KM. Auscultation of bilateral breath sounds does not rule out endobronchial intubation in children. Anesth Analg. 2004;99(1):56–859. Canadian point of care ultrasound society. Protección y desinfección de ecógrafos de carro durante la pandemia por COVID-19 [Internet]. Disinfection protocols for ultrasound machines during COVID-19 management. 2020 [cited 2020 Jun 17]. p. 1–2. Available from: https://www.cpocus.ca/covid19/disinfecting-protocols/60. Ministerio de Salud y Protección Social. Limpieza y Desinfección en Servicios de Salud ante la introducción del nuevo coronavirus (SARS-CoV-2) a Colombia [Internet]. Bogotá, Colombia; 2020 Mar [cited 2020 Jun 17]. Available from: https://www.minsalud.gov.co/Ministerio/Institucional/Procesos y procedimientos/GIPS07.pdf61. Jaeel, P., Sheth, M. & Nguyen, J. Ultrasonography for endotracheal tube position in infants and children. Eur J Pediatr 176, 293–300 (2017). https://doi.org/10.1007/s00431-017-2848-562. Lin, Margaret J. MD1; Gurley, Kiersten MD2; Hoffmann, Beatrice MD, PhD, RDMS2 Bedside Ultrasound for Tracheal Tube Verification in Pediatric Emergency Department and ICU Patients: A Systematic Review*, Pediatric Critical Care Medicine: October 2016 - Volume 17 - Issue 10 - p e469-e476 doi: 10.1097/PCC.000000000000090763. Gottlieb M, Holladay D, Burns KM, Nakitende D, Bailitz J. Ultrasound for airway management: An evidence-based review for the emergency clinician. Am J Emerg Med. 2020 May;38(5):1007-1013. doi: 10.1016/j.ajem.2019.12.019. Epub 2019 Dec 11. PMID: 3184332564. Felipe Cardemil. Análisis de comparación y aplicaciones del método de Bland-Altman: ¿concordancia o correlación? Medwave 2017 Ene-Feb;16(1):e6852 doi:10.5867/medwave.2017.01.685265. Harris, E. A., Arheart, K. L., & Penning, D. H. (2008). Endotracheal tuve malposition within the pediatric population: a common event despite clinical evidence of correct placement. 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