Accuracy in placing oral cuffed endotracheal tube to correct depth in Indian adults based on conventional guidelines

Abstract

Background & Aims: Precise positioning of oral Endotracheal tube (ETT) anytime is difficult however if attained will ease complications of its misplacement. The accuracy in positioning oral cuffed ETTs to the correct depth in Indian adults following conventional guidelines was sought for. Methods: This study was conducted upon 240 adults ageing 20 to 60 years of both sex, who required endotracheal intubation at operation rooms or already intubated due to any reason admitted in CCU of BSMC&H, Bankura, West Bengal, excluding patients with hemodynamic instability and upper airway deformities. Oral ETT intubation was performed and ETT fixed at incisors following conventional guidelines. ETT tip to Carina distance was measured with fiberoptic bronchoscope thereafter. The power of study was kept at 0.95. Obtained data were evaluated with descriptive and inferential statistical tests by Microsoft Excel 2016. Results & Conclusions: Only 60% (n=144) of ETTs were found to be accurately positioned. In the rest 40% (n=96) of misplaced ETTs, the majority (91%, n=87) were placed too deep. Predetermined fixing the ETTs at 21 cm and 23cm mark in females and males respectively leads to deep placement in 36% of them. Hence, we can declare that securing ETT at midline according to the conventional guidelines doesn’t match our Indian people.