Comparison Of Chula Formula With Standard 21/23 Rule For Estimation Of Orotracheal Tube Depth In Intubated Adult Patients: A Sindh Institute Of Urology And Transplantation Experience.

Ramesh Kumar, Fakhir Raza Haidri, Bushra Zafar
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Abstract

Background: The proper estimation of depth of the orotracheal tube (OTT) in intubated patients is difficult. Several methods have been developed for proper estimation of the depth of OTT. The purpose of this study was to compare two commonly used formulae (21/23 rule and Chula formula) for proper estimation of depth of OTT in our Pakistani population.

Methods: In this randomized interventional study, we included 74 adult patients. The study was conducted in the Intensive care unit of a tertiary care hospital in Karachi, Pakistan, from October 2021 to April 2022. Patients were intubated using either the 21/23 rule (OTT was fixed at 21 cm in females and 23 cm in males from the right incisor) or the Chula formula (OTT was fixed at the right incisor according to the height based formula, {(height in cm/10)+4}). The distance between the carina and the OTT tip was measured using the digital chest x-ray with a PACS software.

Results: A total of 74 patients were intubated in which 32 were intubated using 21/23 rule and 42 were intubated using the Chula formula. Four female patients in 21/23 rule group encountered unsafe distance between the carina and the tip of the OTT (i.e., <2 cm) while no such complications were reported in Chula formula group (p-value 0.031).

Conclusions: Chula formula was safe method for OTT placement in our study. Further studies with larger sample size are needed to assess the safety and efficacy of Chula formula for Pakistani Population.

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Chula公式与21/23标准估计成人气管插管深度的比较:信德省泌尿外科和移植研究所的经验。
背景:正确估计气管插管患者的气管插管深度是一个困难的问题。目前已经发展了几种正确估计OTT深度的方法。本研究的目的是比较两种常用的公式(21/23规则和Chula公式),以正确估计我们巴基斯坦人群的OTT深度。方法:在这项随机介入研究中,我们纳入了74名成年患者。该研究于2021年10月至2022年4月在巴基斯坦卡拉奇一家三级护理医院的重症监护室进行。患者插管采用21/23规则(OTT固定在距右切牙21 cm和23 cm处)或Chula公式(OTT固定在距右切牙处,根据身高公式{(身高厘米/10)+4})。使用PACS软件进行数字胸片测量隆突与OTT尖端之间的距离。结果:共74例患者插管,其中32例采用21/23规则插管,42例采用丘拉公式插管。21/23规则组有4例女性患者出现隆突与OTT尖端距离不安全(即:结论:Chula配方在本研究中是一种安全的OTT放置方法。需要进一步开展更大样本量的研究来评估Chula配方对巴基斯坦人群的安全性和有效性。
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