Can the Fluctuation Observed in the Endotracheal Tube with Compression Applied to the Epigastric Region be Used as a Confirmation Method for Endotracheal Intubation?

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dc.contributor.authorBoǧan, Mustafa
dc.contributor.authorAlatlı, Tufan
dc.contributor.authorKarakeçili, Ceren
dc.contributor.authorSelki, Kudret
dc.contributor.authorErdem, Emre
dc.contributor.authorKarakoyun, Salih
dc.contributor.authorKömürcü, Özkan
dc.date.accessioned2025-10-11T20:45:26Z
dc.date.available2025-10-11T20:45:26Z
dc.date.issued2025
dc.departmentDüzce Üniversitesien_US
dc.description.abstractBackground: The traditional methods are mostly used to detect tracheal localization and to exclude esophageal localization. Therefore, the aim of this study was to investigate the usefulness of epigastric manual compression in the confirmation of esophageal placement of the tube. Methods: Out-of-hospital ETE was performed by experienced paramedics working in the emergency ambulance service, while ETE in the emergency department was performed by emergency medicine residents or emergency medicine specialists with at least 2 years of emergency department experience. Epigastric compression was performed by applying pressure to the epigastric region at least three times (in 5 sec) with the volar side of the intubated patient while the patient was ventilated with a balloon-valved mask. Immediately after ETI was performed, Ultrasonography (USG) was performed as the gold standard confirmation method. If a double path sign was observed and the pleural sliding motion was not seen, it was considered unsuccessful. Results: A total of 78 patients were included in the study (an equal number of successful and unsuccessful ETE applications). Approximately 59% (n=46) of the patients were female, median age was 73 years (64-80), and 22(28.2%) patients were intubated due to traumatic etiology. The specificity and sensitivity of epigastric fluctuation for esophageal intubations were 83.33% and 60%, respectively. The positive predictive value was 92.31%, and the negative predictive value was 38.46%. Epigastric auscultation airflow sound had a specificity of 86.96% and a sensitivity of 65.45% for esophageal intubation. Conclusion: Although the fluctuation that occurs in the tube with epigastric compression is not as sensitive and specific as USG, it is a better method than lung auscultation. © 2025 Elsevier B.V., All rights reserved.en_US
dc.identifier.doi10.2174/0102506882369196250326072120
dc.identifier.issn0250-6882
dc.identifier.scopus2-s2.0-105010058684en_US
dc.identifier.scopusqualityQ4en_US
dc.identifier.urihttps://doi.org/10.2174/0102506882369196250326072120
dc.identifier.urihttps://hdl.handle.net/20.500.12684/21359
dc.identifier.volume5en_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherBentham Science Publishersen_US
dc.relation.ispartofNew Emirates Medical Journalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmzKA_Scopus_20250911
dc.subjectBalloon-valved Masken_US
dc.subjectChest X-rayen_US
dc.subjectCpren_US
dc.subjectEndotracheal Intubationen_US
dc.subjectEpigastric Fluctuationen_US
dc.subjectEsophageal Placementen_US
dc.subjectIntubationen_US
dc.titleCan the Fluctuation Observed in the Endotracheal Tube with Compression Applied to the Epigastric Region be Used as a Confirmation Method for Endotracheal Intubation?en_US
dc.typeArticleen_US

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