scholarly journals Predictors of difficult intubation defined by the intubation difficulty scale (IDS): predictive value of 7 airway assessment factors

2012 ◽  
Vol 63 (6) ◽  
pp. 491 ◽  
Author(s):  
Suk-Hwan Seo ◽  
Jeong-Gil Lee ◽  
Soo-Bong Yu ◽  
Doo-Sik Kim ◽  
Sie-Jeong Ryu ◽  
...  
Keyword(s):  
Difficult Intubation ◽  
Predictive Value ◽  
Intubation Difficulty ◽  
Airway Assessment ◽  
Difficulty Scale

scholarly journals Comparison of Laryngoscopic Views between C-MAC™ and Conventional Laryngoscopy in Patients with Multiple Preoperative Prognostic Criteria of Difficult Intubation. An Observational Cross-Sectional Study

Medicina ◽  
2019 ◽  
Vol 55 (12) ◽  
pp. 760
Author(s):  
Aikaterini Amaniti ◽  
Panagiota Papakonstantinou ◽  
Dimitrios Gkinas ◽  
Ioannis Dalakakis ◽  
Evangelia Papapostolou ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Difficult Intubation ◽  
Elective Surgery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cross Sectional Study ◽  
Laryngoscopic View ◽  
Cross Sectional ◽  
Intubation Difficulty ◽  
Difficulty Scale

Background and Objectives: Video laryngoscopy has been proven useful under difficult airway scenarios, but it is unclear whether anticipated improvement of visualization is related to specific difficult intubation prognostic factors. The present study evaluated the change in laryngoscopic view between conventional and C-MAC® laryngoscopy and the presence of multiple difficult intubation risk factors. Materials and Methods: Patients scheduled for elective surgery with >2 difficult intubation factors, (Mallampati, thyromental distance (TMD), interinscisor gap, buck teeth, upper lip bite test, cervical motility, body mass index (BMI)) were eligible. Patients underwent direct laryngoscopy (DL) followed by C-MAC™ laryngoscopy (VL) and intubation. Change of view between DL and VL, time for best view, intubation difficulty scale (IDS) and correlation between prognostic factors, laryngoscopic view improvement, and IDS were measured. Results: One-hundred and seventy-six patients completed the study. VL lead to fewer Cormarck–Lehane (C/L) III-IV, compared to DL (13.6% versus 54.6%, p < 0.001). The time to best view was also shorter (VL: 10.82 s, DL: 12.08 s, p = 0.19). Mallampati III-IV and TMD ≤ 6 cm were related to improvement of C/L between DL and VL. Logistic regression showed these two factors to be a significant risk factor of the glottis view change (p = 0.006, AUC-ROC = 0.57, 95% CI: 0.47–0.66). 175/176 patients were intubated with VL. 108/176 were graded as 0 < IDS ≤ 5 and 12/176 as IDS > 5. IDS was only correlated to the VL view (p < 0.0001). Conclusion: VL improved laryngoscopic view in patients with multiple factors of difficult intubation. Mallampati and TMD were related to the improved view. However, intubation difficulty was only related to the VL view and not to prognostic factors.

scholarly journals Comparison of Upper Lip Bite Test with Modified Mallampati Test and Thyromental Distance for Prediction of Difficult Intubation

2020 ◽  
Vol 5 (1) ◽  
pp. 2-9
Author(s):  
Sabin Koirala ◽  
Bigen Man Shakya ◽  
Moda Nath Marhatta
Keyword(s):  
Difficult Intubation ◽  
Predictive Value ◽  
Elective Surgery ◽  
Cross Sectional Study ◽  
Upper Lip ◽  
Cross Sectional ◽  
Airway Assessment ◽  
Total Percentage ◽  
Bedside Test ◽  
Sensitivity Specificity

Introduction: The prediction of difficult intubation using simple bedside test is of great importance to prevent mismanagement of airway. This study was conducted to compare Upper Lip Bite Test (ULBT) with Modified Mallampati Test (MMT) and Thyromental Distance (TMD) for the prediction of difficult intubation. Method: This was descriptive cross-sectional study conducted in 121 patients of  American Society of Anaesthesiologists Physical Status (ASA PS) I and II patients scheduled for elective surgery requiring general anaesthesia with endotracheal tube. The airway assessment of the patients was done one day prior to the surgery using Upper Lip Bite Test (ULBT), Modified Mallampati Test (MMT) and measurement of Thyromental Distance (TMD) . On the day of surgery during laryngoscopy, Cormack-Lehane (CL) grading was recorded. The CL grading of III and IV was labeled as difficult intubation. The Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Likelihood Ratio (LR) of ULBT, MMT and TMD were calculated and compared. Results: The total percentage of difficult intubation, defined by Cormack-Lehane (CL) III and IV was 16.52 %. The sensitivity, specificity, PPV, NPV and accuracy of Upper Lip Bite Test (ULBT) was 50%, 100%, 100%, 91% and 91.74% respectively. ULBT had a significantly higher sensitivity, specificity and PPV when compared to MMT or  TMD or MMT and TMD when combined together. Conclusions:  Upper Lip Bite Test (ULBT) is better   predictor of difficult intubation  and it should be used along with other test during airway assessment.

Determination of the changes in the hypoglossal nerve function after suspension laryngoscopy with needle electromyography of the tongue

2004 ◽  
Vol 118 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Ugur Cinar ◽  
Gokhan Akgul ◽  
Huseyin Seven ◽  
Munevver Celik ◽  
Surhan Cinar ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Hypoglossal Nerve ◽  
Nerve Function ◽  
Intubation Difficulty ◽  
Needle Electromyography ◽  
Airway Assessment ◽  
Significant Difference ◽  
Difficulty Scale ◽  
Suspension Laryngoscopy

The purpose of this study was to determine changes in the hypoglossal nerve function after suspension laryngoscopy with needle electromyography of the tongue. This study also attempted to determine the possible relationship between the predictive factors of intubation difficulty by using the intubation difficulty scale, which was introduced by Adnet et al., duration of suspension laryngoscopy and changes in hypoglossal nerve function after suspension laryngoscopy. The study was performed on 39 patients who underwent suspension laryngoscopy for benign glottic pathology. Pre-operative airway assessment was evaluated by the intubation difficulty scale and the duration of suspension laryngoscopy was recorded. Needle electromyography of the tongue was performed three or four weeks after the suspension laryngoscopy. After needle electromyography of the tongue, increased polyphasia was found in 13 patients (33 per cent), bilaterally in three of them. The interference pattern was reduced in two of these 13 patients. There was no statistically significant difference in predictive factors of intubation difficulty and the duration of the operation between these 13 patients with increased polyphasiaand the remaining 26 patients with completely normal electromyography findings. These findings show that, in spite of normal clinical tongue function, subclinical changes can be detected by needle electromyography of the tongue after suspension laryngoscopy.

scholarly journals Short Neck, a new criterion for airway assessment A pilot, cohort single blind study

2020 ◽  
Author(s):  
jafar faraj ◽  
Yasir E. Ahmed ◽  
Chetankumar B. Raval ◽  
Taisir M Yousif ◽  
Neeraj Kumar ◽  
...  
Keyword(s):  
Elective Surgery ◽  
P Value ◽  
Short Neck ◽  
Neck Length ◽  
Intubation Difficulty ◽  
Airway Assessment ◽  
Difficulty Scale ◽  
Group B ◽  
Difficulty Score ◽  
New Criterion

Abstract Purpose Short Neck is a term used by anesthesiologists to describe one of the risk factors for difficult airway management. However, the term Short Neck is very subjective and has not been standardized. We attempt to quantify Short Neck.Methods A pilot prospective single blinded study was conducted at Hamad General Hospital, Doha, Qatar between March 2018 and October 2018. 97 adult patients scheduled for elective surgery under general anesthesia were recruited. Measurements of airway assessment, including neck length, were documented prior to anesthesia. The operators (anesthesiologists) were blinded. Intubation Difficulty Scale was used. All data were documented and analysed afterwards. Patients were of three groups according to Intubation Difficulty Scale (IDS): Group A: IDS 0, Group B: IDS >0 - ≤5 and Group C: IDS >5.Results Five patients (5.2%) with intubation difficulty score >5 have a mean neck length 7.6 cm. Short Neck was found to have a significant p value 0.022 within the three groups.Conclusions Patient's features relevant to airway assessment are rather difficult to quantify. This is the first reported attempt to obtain an objective value for Short Neck in routine airway assessment.

scholarly journals Comparison of Upper Lip Bite Test with Modified Mallampati Score in Predicting Difficult Intubation

2022 ◽  
Vol 7 (1) ◽  
pp. 1-8
Author(s):  
Monish Thomas ◽  
Nichelle M. Saldanha
Keyword(s):  
Difficult Airway ◽  
Endotracheal Intubation ◽  
Difficult Intubation ◽  
Anaesthetic Management ◽  
Class Iii ◽  
Upper Lip ◽  
Intubation Difficulty ◽  
Mallampati Score ◽  
Difficulty Scale ◽  
A Prospective Study

Background and Aims: Identifying a patient with a difficult airway is important in planning anaesthetic management so that endotracheal intubation can be achieved safely. This study aims to compare modified Mallampati score with Upper Lip Bite Test to predict difficult intubation using intubation difficulty scale. Materials and methods: A prospective study was carried on 104 patients, both sexes aged between 18 to 60 years scheduled for elective surgeries under general anaesthesia fulfilling inclusion and exclusion criteria. Patient airway was evaluated by MMT and ULBT preoperatively. Predictors of difficult endotracheal intubation were assigned to MMT class III and IV, ULBT class III. After premedication and induction laryngoscopy was performed. After successful intubation Intubation difficulty score was noted down based on the sum of seven assessing parameters. A score >5 was considered difficult intubation. Results: The incidence of difficult intubation in the study was 10.6% (i.e. 11 out of 104 patients). In this study ULBT had a higher sensitivity (90.9% v/s 18.20%), specificity (95.7% v/s 75.3%) PPV (71.4% v/s 8%) and NPV (98.9% v/s 88.6%) than that of MMT Conclusion: Upper lip bite test is better at predicting difficult intubation with higher accuracy when compared to Modified Mallampati test. Both the tests are good predictors of easy intubation. Keywords: Upper Lip Bite Test (ULBT), Modified Mallampati test (MMT), Intubation Difficulty scale (IDS), airway assessment. Difficult intubation prediction, Difficult airway

scholarly journals Relationship of neck circumference and difficult endotracheal intubation in obese patients

2017 ◽  
Vol 4 (2) ◽  
pp. 3-9
Author(s):  
Amit Kumar Karna ◽  
Khalid Bashir
Keyword(s):  
Endotracheal Intubation ◽  
Difficult Intubation ◽  
Pearson Correlation ◽  
Anesthetic Management ◽  
Cricoid Cartilage ◽  
Neck Circumference ◽  
Obese Patients ◽  
Patient Identification ◽  
Intubation Difficulty ◽  
Difficulty Scale

Background and Objectives: Patient identification with difficult intubation is important in planning anesthetic management and one major factor for difficult intubation in t he obese patients is large neck circumference. The need for prediction of a potentially difficult airway received great importance as it plays a significant role in reducing morbidity and mortality. Therefore, this study was done to glimpse the effect of neck circumference on endotracheal intubation and to determine the frequency of difficult intubation.Material and Methods: The study was cross sectional descriptive study and convenient sampling technique was used. Seventy patients of age between 19-50 years of both sexes were enrolled. Neck circumference was measured at the level of cricoid cartilage along with other airway assessments. Direct laryngoscopy was done and checked whether it is difficult one or easy using Intubation difficulty scale. Data were entered and analyzed by using statistical software SPSS version 15.0. Results: Mean BMI was noted as 33.02±2.30 kg/m2 and the mean neck circumference was 43.64±2.30 cm. Difficult intubation was observed in 23 (32.86%) patients with mean neck circumference of 45.44±1.88 cm and normal intubation observed in 47(67.14%) patients with mean neck circumference of 42.77±1.98 cm. Linear correlation was found between the neck circumference and Intubation Difficulty Scale score with value of Pearson correlation=0.617 .Conclusion: Neck circumference of patient was found to have significant effects on difficult intubation. Frequency of difficult intubation was found in almost one third of obese patients with increasing neck circumference.Janaki Medical College Journal of Medical Sciences (2016) Vol. 4 (2): 3-9 

scholarly journals Comparative Evaluation of Difficult Intubation Predictors in Children Under Two Years of Ages

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sedige Shahhosseini ◽  
Mohammad Montasery ◽  
Mohammadali Saadati ◽  
Amir Shafa
Keyword(s):  
Difficult Intubation ◽  
Comparative Evaluation ◽  
Analytical Study ◽  
Elective Surgery ◽  
Mouth Opening ◽  
Suprasternal Notch ◽  
Pediatric Airway ◽  
Intubation Difficulty ◽  
Difficulty Scale ◽  
Difficult Cases

Background: Tracheal intubation is the most reliable way of securing an airway. Pediatric airway management is one of the significant challenges, especially for non-pediatric anesthesiologists. Early airway evaluation for detecting difficult intubation and preventing catastrophic events is necessary before anesthesia, especially in children. Objectives: Therefore, this study was done to compare some valuable adult predictors in children under two years of age. Methods: This prospective descriptive-analytical study was performed on 405 children under two years of age that were referred for elective surgery under general anesthesia with endotracheal intubation in Imam Hossein Hospital, Isfahan. Under sedation in a supine position, we measured items, including age, weight, height, stern omental distance (SMD), mouth opening (MO), neck circumference (NC), acromio-axillo-suprasternal notch index (AASI), and intubation difficulty scale score (IDS). An expert anesthesiologist did laryngoscopy and intubation, and difficult cases were recorded. Results: Our study showed that the frequency of difficult intubation with IDS > 4 was %16, and with IDS > 5 was %3. The variables, including age, weight, height, and SMD, significantly predicted difficult intubation. The cut-off points for age < 6 months, weight < 5/9 kg, height < 61 cm, and SMD < 5/3 cm were obtained, respectively. Other variables, such as MO, AASI, NC, and sex, were unreliable predictors for difficult intubation. Conclusions: We found that IDS > 4, age< 6-month, weight < 5/9 kg, and SMD < 5/3 cm are predictors for difficult intubation. It is helpful for the anesthesiologist to measure these predictions before anesthesia is started to find who has difficult intubation.

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