Correlation between oro and hypopharynx shape and position with endotracheal intubation difficulty
Background and objective: Prediction of intubation difficulty can save patients from major preoperative morbidity or mortality. The purpose of this paper is to assess the correlation between oro-hypo pharynx position, neck size, and length with endotracheal intubation difficulty. The study also explored the diagnostic value of Friedman Staging System in prediction cases with difficult intubation. Method: The consecutive 500 ASA (I, II) adult patients undergoing elective surgery were evaluated for oro and hypopharynx shape and position by modified Mallampati, Cormack and Lehane score as well as Friedman obstructive sleep apnea classification systems. Neck circumference and length were also measured. All cases were intubated by a single anesthesiologist who was uninformed of the above evaluation and graded intubation difficulty in visual analog score. Correlation between these findings and difficulty of intubation was assessed. Sensitivity, Specificity, Positive and Negative Predictive Values were also reported. Results: Cormack-Lehane grade had the strongest correlation with difficulty of intubation followed by Friedman palate position. Friedman palate position was the most sensitive and had higher positive and negative predictive values than modified Mallampati classification. Cormack-Lehane grade was found to be the most specific with the highest negative predictive value among the four studied classifications. Conclusion: Friedman palate position is a more useful, valuable and sensitive test compared to the modified Mallampati screening test for pre-anesthetic prediction of difficult intubation where its involvement in Multivariate model may raise the accuracy and diagnostic value of preoperative assessment of difficult airway.
Main Authors: | , , |
---|---|
Format: | Digital revista |
Language: | English |
Published: |
Sociedade Brasileira de Anestesiologia
2014
|
Online Access: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942014000600433 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
oai:scielo:S0034-70942014000600433 |
---|---|
record_format |
ojs |
spelling |
oai:scielo:S0034-709420140006004332015-08-25Correlation between oro and hypopharynx shape and position with endotracheal intubation difficultyRabadi,DaherBaker,Ahmad AbuAl-Qudah,Mohannad Intubation Airway Pharynx Classification Correlation Value Background and objective: Prediction of intubation difficulty can save patients from major preoperative morbidity or mortality. The purpose of this paper is to assess the correlation between oro-hypo pharynx position, neck size, and length with endotracheal intubation difficulty. The study also explored the diagnostic value of Friedman Staging System in prediction cases with difficult intubation. Method: The consecutive 500 ASA (I, II) adult patients undergoing elective surgery were evaluated for oro and hypopharynx shape and position by modified Mallampati, Cormack and Lehane score as well as Friedman obstructive sleep apnea classification systems. Neck circumference and length were also measured. All cases were intubated by a single anesthesiologist who was uninformed of the above evaluation and graded intubation difficulty in visual analog score. Correlation between these findings and difficulty of intubation was assessed. Sensitivity, Specificity, Positive and Negative Predictive Values were also reported. Results: Cormack-Lehane grade had the strongest correlation with difficulty of intubation followed by Friedman palate position. Friedman palate position was the most sensitive and had higher positive and negative predictive values than modified Mallampati classification. Cormack-Lehane grade was found to be the most specific with the highest negative predictive value among the four studied classifications. Conclusion: Friedman palate position is a more useful, valuable and sensitive test compared to the modified Mallampati screening test for pre-anesthetic prediction of difficult intubation where its involvement in Multivariate model may raise the accuracy and diagnostic value of preoperative assessment of difficult airway. info:eu-repo/semantics/openAccessSociedade Brasileira de AnestesiologiaRevista Brasileira de Anestesiologia v.64 n.6 20142014-12-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942014000600433en10.1016/j.bjane.2013.08.003 |
institution |
SCIELO |
collection |
OJS |
country |
Brasil |
countrycode |
BR |
component |
Revista |
access |
En linea |
databasecode |
rev-scielo-br |
tag |
revista |
region |
America del Sur |
libraryname |
SciELO |
language |
English |
format |
Digital |
author |
Rabadi,Daher Baker,Ahmad Abu Al-Qudah,Mohannad |
spellingShingle |
Rabadi,Daher Baker,Ahmad Abu Al-Qudah,Mohannad Correlation between oro and hypopharynx shape and position with endotracheal intubation difficulty |
author_facet |
Rabadi,Daher Baker,Ahmad Abu Al-Qudah,Mohannad |
author_sort |
Rabadi,Daher |
title |
Correlation between oro and hypopharynx shape and position with endotracheal intubation difficulty |
title_short |
Correlation between oro and hypopharynx shape and position with endotracheal intubation difficulty |
title_full |
Correlation between oro and hypopharynx shape and position with endotracheal intubation difficulty |
title_fullStr |
Correlation between oro and hypopharynx shape and position with endotracheal intubation difficulty |
title_full_unstemmed |
Correlation between oro and hypopharynx shape and position with endotracheal intubation difficulty |
title_sort |
correlation between oro and hypopharynx shape and position with endotracheal intubation difficulty |
description |
Background and objective: Prediction of intubation difficulty can save patients from major preoperative morbidity or mortality. The purpose of this paper is to assess the correlation between oro-hypo pharynx position, neck size, and length with endotracheal intubation difficulty. The study also explored the diagnostic value of Friedman Staging System in prediction cases with difficult intubation. Method: The consecutive 500 ASA (I, II) adult patients undergoing elective surgery were evaluated for oro and hypopharynx shape and position by modified Mallampati, Cormack and Lehane score as well as Friedman obstructive sleep apnea classification systems. Neck circumference and length were also measured. All cases were intubated by a single anesthesiologist who was uninformed of the above evaluation and graded intubation difficulty in visual analog score. Correlation between these findings and difficulty of intubation was assessed. Sensitivity, Specificity, Positive and Negative Predictive Values were also reported. Results: Cormack-Lehane grade had the strongest correlation with difficulty of intubation followed by Friedman palate position. Friedman palate position was the most sensitive and had higher positive and negative predictive values than modified Mallampati classification. Cormack-Lehane grade was found to be the most specific with the highest negative predictive value among the four studied classifications. Conclusion: Friedman palate position is a more useful, valuable and sensitive test compared to the modified Mallampati screening test for pre-anesthetic prediction of difficult intubation where its involvement in Multivariate model may raise the accuracy and diagnostic value of preoperative assessment of difficult airway. |
publisher |
Sociedade Brasileira de Anestesiologia |
publishDate |
2014 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942014000600433 |
work_keys_str_mv |
AT rabadidaher correlationbetweenoroandhypopharynxshapeandpositionwithendotrachealintubationdifficulty AT bakerahmadabu correlationbetweenoroandhypopharynxshapeandpositionwithendotrachealintubationdifficulty AT alqudahmohannad correlationbetweenoroandhypopharynxshapeandpositionwithendotrachealintubationdifficulty |
_version_ |
1756376307329925120 |