Pre-operative transnasal endoscopy as a predictor of difficult airway: A prospective cohort study.
Eur J Anaesthesiol
; 37(2): 98-104, 2020 Feb.
Article
en En
| MEDLINE
| ID: mdl-31789897
ABSTRACT
BACKGROUND:
Consequences of failed endotracheal intubation can be catastrophic and predicting difficulty is therefore a critical issue. There is no consensus on the best way to predict difficulty.OBJECTIVE:
To evaluate the role of transnasal flexible endoscopic laryngoscopy (TFEL), a minimally invasive procedure, in the prediction of difficult intubation.DESIGN:
Prospective cohort study.SETTING:
San Raffaele Hospital, Milan, a tertiary university hospital. PATIENTS One hundred and sixty nine adults scheduled for elective ear, nose and throat surgery under general anaesthesia with pre-operative TFEL. INTERVENTION In addition to routine pre-operative evaluation by an anaesthesiologist, glottis exposure during TFEL was assessed with a scoring system similar to the modified Cormack-Lehane (MCL). MAIN OUTCOMEMEASURES:
The extent to which TFEL improves the prediction of difficult direct laryngoscopy, measured with the MCL score, and of difficult intubation, measured with the intubation difficulty scale score.RESULTS:
When added to bedside evaluation, TFEL performed during tongue protrusion significantly (Pâ=â0.005) improved the prediction of MCL. The area under the receiver operating characteristics curve was 0.75 [95% confidence interval (CI) 0.67 to 0.83] vs. 0.65 (95% CI 0.58 to 0.74). For the intubation difficulty scale (Pâ=â0.049), the area under the receiver operating characteristics curve was 0.70 (95% CI 0.61 to 0.80) vs. 0.66 (95% CI 0.58 to 0.74).CONCLUSION:
TFEL is a useful tool in predicting difficult intubation, improving predictability of routine bedside evaluation. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02671877.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Intubación Intratraqueal
/
Laringoscopía
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Eur J Anaesthesiol
Asunto de la revista:
ANESTESIOLOGIA
Año:
2020
Tipo del documento:
Article