The challenges of using ultrasound to measure the trachea

Newman, H., Allen, J., Narayanan, M., Obonyo, N., Syahrunnizar, N., Hammet, K., Parry, D., Wallace, S., Sutt, A.-L., Osterwalder, J., Martin, D. Critical Care DOI: 10.1186/s13054-025-05499-0

Abstract: Tracheostomy is a common procedure in intensive care medicine, involving the insertion of an artificial airway through the front of the neck into the trachea. The size of tracheostomy tube in relation to the trachea is important, influencing clinical outcomes and patient experience. Ultrasound is readily available at the bedside and airway applications have been reported, including airway measurement. However, the presence of air within airway lumina presents challenges to ultrasound and causes artefact. Guidance is lacking on tracheal sonography and measurement.