{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:05:48Z","timestamp":1789646748310,"version":"4.0.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Most endotracheal tube (ETT) depth assessment methods require extra equipment or expertise. Suprasternal tactile cuff ballotability is a bedside technique; however, its performance against a radiographic standard is not well characterised. This study assessed the accuracy of identifying an ETT cuff position above the lower border of the second thoracic vertebral body (T2LB) on fluoroscopy, interobserver agreement, and the relationship with tip-to-carina distance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective observational study enroled adults undergoing neuroradiological procedures under general anaesthesia. After intubation, cuff ballotability was assessed by compressing the pilot balloon while palpating the trachea cephalad to the suprasternal notch. Ballotability, ETT marking at the mouth angle, and tip-to-carina distance were recorded. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with 95% confidence intervals (CIs) were calculated. Interobserver agreement used Fleiss\u2019 Kappa (k).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 85 screened patients, 76 were recruited [mean age 43.58 (13.47) years], and 72 underwent analysis. The correct placement prevalence was 72%. The sensitivity was 98.08% (94.90%\u2013100%), specificity 60.00% (46.68%\u201371.32%), PPV 86.44% (78.53%\u201394.35%), and NPV 92.31% (86.15%\u201398.46%). The interobserver agreement was excellent (\u03ba = 0.77,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The tip-to-carina distance was greater with ballotability (mean difference 17.9 mm;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this study of non-obese adults under general anaesthesia, suprasternal tactile cuff ballotability had high sensitivity (98.1%) but moderate specificity (60.0%) for identifying the radiographic cuff position at or above T2 vertebral body, with excellent interobserver agreement (\u03ba = 0.77).<\/jats:p>\n                  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