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Diagnostic Accuracy of Point-of-care Ultrasonography for Confirming Endotracheal Tube Placement in Adults: An Updated Systematic Review and Meta-analysis
Journal article   Open access

Diagnostic Accuracy of Point-of-care Ultrasonography for Confirming Endotracheal Tube Placement in Adults: An Updated Systematic Review and Meta-analysis

Mohammed A Alsabri, Ahmed B Elsnhory, Mohammed T Hasan, Christopher H McClean, Khaled Abouelmagd, Eslam Abady, Abdelrahman M Tawfik, Michael Lajeunesse, Amira A Aboali, Patrick Yoo, …
Indian journal of critical care medicine, v 30(2), pp 155-164
13 Feb 2026
DOI: https://doi.org/10.5005/jp-journals-10071-25152
url
https://doi.org/10.5005/jp-journals-10071-25152View
Published, Version of Record (VoR) Open

Abstract

Airway management Critical care Diagnostic accuracy Emergency airway management Endotracheal intubation Point-of-care ultrasonography Ultrasonography
Background: Point-of-care ultrasonography (POCUS) is increasingly used to confirm endotracheal tube (ETT) placement; however, its overall diagnostic accuracy and speed compared with standard methods in adult emergency and critical care settings remain uncertain. Methods: We conducted a systematic review and meta-analysis of observational studies through May 2025 that evaluated POCUS for confirming ETT placement in adults (≥18 years) in emergency departments (EDs) and intensive care units (ICUs). Results: Thirty studies met the inclusion criteria. Point-of-care ultrasonography achieved a pooled sensitivity of 0.91 and a specificity of 0.98. The area under the curve (AUC) was 0.96 [95% confidence interval (CI): 0.88–1.00]. The mean time-to-confirmation was 19.62 seconds for POCUS vs 22.46 seconds for standard methods; however, this finding should be interpreted with caution due to extreme heterogeneity (I² > 99%). Conclusion: Point-of-care ultrasonography is a highly accurate, rapid, and reliable method for confirming ETT placement in adult ED and ICU settings. It demonstrates diagnostic performance comparable to previously reported capnography performance and provides unique advantages as an adjunctive tool, especially in scenarios where capnography may be unreliable.

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