Clinical trial NCT05439109: Correct Endotracheal Tube Placement Using Topographical Landmarks
Official title: To Evaluate the Appropriate Depth of Endotracheal Tube Placement Guided by Topographical Landmarks
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Intubation, Intratracheal
Anatomic Landmarks
Keywords: Endotracheal tube placement
Topographical landmarks of trachea
Lead sponsor: Rajiv Gandhi Cancer Institute & Research Center, India
Sponsor class: OTHER
First posted: 2022-06-30
Enrollment: 400
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: All enrolled patients will be intubated by either topographical landmarks of individual tracheal dimensions or by the conventional intubation guide method.
Primary purpose: PREVENTION

Brief summary: An optimal endotracheal tube depth is ideally required for preventing the complications associated with mal-positioning of the endotracheal tube. The topographical technique of tube placement considering the individual's morphometric dimensions could help to provide optimal tube placement. hence, to evaluate the efficacy of the topographical technique in providing the optimal tube placement this study will be conducted.

Detailed description: The trachea is a dynamic organ and its length varies by various static and dynamic factors leading to changing the tracheal length and variable endotracheal tube tip to carina (Ti-Ca) distance. Hence, upholding optimal Ti-Ca distance during changing tracheal length is of utmost importance to prevent complications associated with endotracheal tube (ETT) mal-positioning. When the length of ETT, which is to be inserted inside the trachea, is calculated as per an individual's tracheal morphometric dimensions, the appropriate depth of placement could be achieved and tube malpositioning can be prevented. In the topographical landmark technique, an individual tracheal length is estimated by measuring the various distance from mid-thyroid level (corresponds to vocal cords) to manubriosternal joint (corresponds to carina) in the sagittal plane. After estimating the tracheal length, tip to carina distance of 3cm was deducted from the estimated length of the trachea to provide the distance of the endotracheal tube to be kept beyond the vocal cords. Hence, the investigators planned this study to find the "utility and reliability" of the topographical landmark technique compared to the conventional intubation guide mark technique in providing the appropriate depth of endotracheal tube placement.

Eligibility criteria: Inclusion Criteria:

* • Age group of 18-75 years

  * ASA physical status I-III patients
  * Oral intubation for general anesthesia

Exclusion Criteria:

* • Patient with upper airway fibrosis

  * Tracheal stenosis or tracheal surgeries
  * Previous head and neck surgeries
  * Contracture neck or irradiated neck
  * Large neck swelling distorting or deviating the trachea
  * Laryngeal or tracheal tumor
  * Intubations requiring flexo-metallic tubes
  * Patient refusal

Primary outcomes:
measure: Endotracheal tube position inside the trachea
timeFrame: through study completion approximately at six months
Secondary outcomes:
Other outcomes:
Locations:
city: Rohini
country: India
facility: Amit
state: Delhi
Study officials:
affiliation: Senior Consultant, Department of Anesthesiology, Rajiv Gandhi Cancer Institute and Research centre
name: Amit K Mittal, M.D
role: PRINCIPAL_INVESTIGATOR
References: