scholarly journals Difficult Mask Ventilation in Obese Patients: New Predictive Tests?

2019 ◽  
Vol 57 (1) ◽  
pp. 15-19
Author(s):  
Bengü Gülhan Aydın ◽  
Gamze Küçükosman ◽  
Özcan Pişkin ◽  
Rahşan Dilek Okyay ◽  
Hilal Ayoğlu
Keyword(s):  
Obese Patients ◽  
Mask Ventilation ◽  
Predictive Tests ◽  
Difficult Mask Ventilation

scholarly journals Predictive factors for difficult mask ventilation in the obese surgical population

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 239 ◽  
Author(s):  
Davide Cattano ◽  
Anastasia Katsiampoura ◽  
Ruggero M. Corso ◽  
Peter V. Killoran ◽  
Chunyan Cai ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Negative Likelihood Ratio ◽  
Positive Pressure ◽  
Obese Patients ◽  
Mask Ventilation ◽  
Difficult Mask Ventilation ◽  
Two Factors

BackgroundDifficult Mask Ventilation (DMV), is a situation in which it is impossible for an unassisted anesthesiologist to maintain oxygen saturation >90% using 100% oxygen and positive pressure ventilation to prevent or reverse signs of inadequate ventilation during mask ventilation.  The incidence varies from 0.08 – 15%. Patient-related anatomical features are by far the most significant cause.  We analyzed data from an obese surgical population (BMI> 30 kg/m2) to identify specific risk and predictive factors for DMV.MethodsFive hundred and fifty seven obese patients were identified from a database of 1399 cases associated with preoperative airway examinations where mask ventilation was attempted. Assessment of mask ventilation in this group was stratified by a severity score (0-3), and a step-wise selection method was used to identify independent predictors.  The area under the curve of the receiver-operating-characteristic was then used to evaluate the model’s predictive value. Adjusted odds ratios and their 95% confidence intervals were also calculated.ResultsDMV was observed in 80/557 (14%) patients. Three independent predictive factors for DMV in obese patients were identified: age 49 years, short neck, and neck circumference  43 cm. In the current study th sensitivity for one factor is 0.90 with a specificity 0.35. However, the specificity increased to 0.80 with inclusion of more than one factor.ConclusionAccording to the current investigation, the three predictive factors are strongly associated with DMV in obese patients. Each independent risk factor alone provides a good screening for DMV and two factors substantially improve specificity. Based on our analysis, we speculate that the absence of at least 2 of the factors we identified might have a significant negative predictive value and can reasonably exclude DMV, with a negative likelihood ratio 0.81.

Correlation of Neck Circumference with Difficult Mask Ventilation and Difficult Laryngoscopy in Morbidly Obese Patients: an Observational Study

2018 ◽  
Vol 28 (9) ◽  
pp. 2860-2867 ◽  
Author(s):  
Aylin Özdilek ◽  
Cigdem Akyol Beyoglu ◽  
Şafak Emre Erbabacan ◽  
Birsel Ekici ◽  
Fatiş Altındaş ◽  
...  
Keyword(s):  
Observational Study ◽  
Neck Circumference ◽  
Difficult Laryngoscopy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Mask Ventilation ◽  
Difficult Mask Ventilation

Neck circumference as a predictor of difficult intubation and difficult mask ventilation in morbidly obese patients

2016 ◽  
Vol 33 (4) ◽  
pp. 244-249 ◽  
Author(s):  
Waleed Riad ◽  
Mercedeh N. Vaez ◽  
Ravi Raveendran ◽  
Amanda D. Tam ◽  
Fayez A. Quereshy ◽  
...  
Keyword(s):  
Difficult Intubation ◽  
Neck Circumference ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Mask Ventilation ◽  
Difficult Mask Ventilation

Prediction of difficult mask ventilation

2005 ◽  
Vol 22 (8) ◽  
pp. 638-640 ◽  
Author(s):  
P. Gautam ◽  
T. K. Gaul ◽  
N. Luthra
Keyword(s):  
Mask Ventilation ◽  
Difficult Mask Ventilation

scholarly journals Utilization of apnea-hypopnea index as a novel predictive factor for difficult mask ventilation in the Chinese population under general anesthesia

2021 ◽  
Author(s):  
Jiayi Wang ◽  
Jingjie Li ◽  
Pengcheng Zhao ◽  
Xuan Pu ◽  
Rong Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elective Surgery ◽  
Chinese Patients ◽  
Apnea Hypopnea Index ◽  
Mask Ventilation ◽  
Clinical Predictors ◽  
Clinical Trial Registry ◽  
Difficult Mask Ventilation ◽  
Obstructive Sleep ◽  
Threatening Situation

Abstract Purpose Difficult mask ventilation (DMV) is a potentially life-threatening situation that can arise during anesthesia. However, most clinical predictors of DMV are based on European and US populations. On the other hand, most predictive models consist of multiple factors and complicated assessments. Since obstructive sleep apnea (OSA) is among the most important risk factors associated with DMV, the apnea-hypopnea index (AHI) may play an important role in determining patient risk.The purpose of this study was to investigate the relationship between DMV and AHI, and to determine preoperative risk factors for DMV in Chinese patients. Methods A prospective cohort trial enrolled patients scheduled for elective surgery. After obtaining informed consent, patient demographic information was collected, and patients were tested with pre-operative polysomnography. The anesthesiologist who managed the airway graded the mask ventilation. The difficult mask ventilation was defined as the mask ventilation provided by an unassisted anesthesiologist without oral airway or other adjuvant. A logistic regression model was used to analyze the association between AHI and DMV. Results A total of 159 patients were analyzed. For both primary and secondary outcomes, the unadjusted and adjusted odds ratio for DMV showed significant increases by 5 AHI units. AHI, age, and the Mallampati classification were found to be independent predictive factors for DMV. Conclusions AHI is associated with DMV as a novel independent risk factor in Chinese patients. Along with age and Mallampati classification, AHI should be included in establishing a superior predictive strategy for DMV screening. Trial registration Chinese Clinical Trial Registry ChiCTR-DDD-17013076

scholarly journals Effectiveness and Safety of a Novel Approach for Management of Patients with Potential Difficult Mask Ventilation and Tracheal Intubation

2018 ◽  
Vol 131 (6) ◽  
pp. 631-637 ◽  
Author(s):  
Ji-Ming Wang ◽  
Er-Li Ma ◽  
Qing-Ping Wu ◽  
Ming Tian ◽  
Yan-Yan Sun ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Mask Ventilation ◽  
Difficult Mask Ventilation ◽  
Novel Approach

scholarly journals Utilization of apnea-hypopnea index as a novel predictive factor for difficult mask ventilation in the Chinese population under general anesthesia

2020 ◽  
Author(s):  
Jia-Yi Wang ◽  
Jing-Jie Li ◽  
Peng-Cheng Zhao ◽  
Jia-Li Peng ◽  
Rong Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Elective Surgery ◽  
Chinese Patients ◽  
Apnea Hypopnea Index ◽  
Mask Ventilation ◽  
Clinical Trial Registry ◽  
Difficult Mask Ventilation ◽  
Physical Status Classification ◽  
Obstructive Sleep

Abstract Background: Difficult Mask Ventilation (DMV) is a potentially life-threatening situation that can arise during anesthesia. Accordingly, the majority of current airway management guidelines include risk assessments for DMV. Although Obstructive Sleep Apnea (OSA) is among the most important risk factors associated with DMV, other measurements such as the Apnea-Hypopnea Index (AHI) may play an important role in determining patient risk.This study investigated the relationship between DMV and AHI, and determined preoperative risk factors for DMV in Chinese patients.Methods: A prospective cohort trial enrolled patients scheduled for elective surgery. After obtaining informed consent, patient demographic information was collected, and patients were tested with pre-operative polysomnography. Inclusion criteria: Patients >18 years of age, American Society of Anesthesiologists Physical Status Classification (ASA) I-III, and planned elective surgery with general anesthesia. Exclusion criteria: malformations of the airway, patients undergoing regional anesthesia, and patients with contraindications to mask ventilation (i.e. planned awake intubation). A logistic regression model was used to analyze the association between AHI and DMV. Results: A total of 159 patients were analyzed. For both primary and secondary outcomes, the unadjusted and adjusted odds ratio for DMV showed significant increases of 5 AHI units. AHI, age, and the Mallampati classification were found to be independent predictive factors for DMV.Conclusions AHI is associated with DMV as a novel independent risk factor in Chinese patients. Along with age and Mallampati classification, AHI should be included in establishing a superior predictive strategy DMV screening.Trial registration: Chinese Clinical Trial Registry (Registration number # ChiCTR17013076; Date of Registration on October 22nd, 2017).

Sign in / Sign up

Export Citation Format

Share Document