Diagnostic accuracy of point-of-care ultrasound for confirming endotracheal tube placement in pediatric acute care settings: a systematic review and meta-analysis

POCUS is a highly sensitive, rapid, radiation-free, and feasible adjunct method for confirming endotracheal placement in critically ill pediatric patients. This integration could reduce the risk of complications associated with ETT misplacement, thereby improving patient outcomes. This meta-analysis finds that POCUS is a highly sensitive adjunct for confirming pediatric ETT placement. However, the pooled specificity was only moderate, and significant heterogeneity across studies in populations, settings, and techniques was a major finding. This variability currently limits its utility as a standalone test. Our results underscore the need for standardized protocols and operator training to improve specificity and consistency before POCUS can be more broadly relied upon for this critical task.