Bedside tests to predict laryngoscopic difficulty in pediatric patients

Detalhes bibliográficos
Autor(a) principal: Mansano, André Marques [UNESP]
Data de Publicação: 2016
Outros Autores: Módolo, Norma Sueli Pinheiro [UNESP], Silva, Leopoldo Muniz da [UNESP], Ganem, Eliana Maria [UNESP], Braz, Leandro Gobbo [UNESP], Knabe, Andrea de Carvalho [UNESP], Freitas, Fernanda Moreira de [UNESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://dx.doi.org/10.1016/j.ijporl.2016.01.031
http://hdl.handle.net/11449/172650
Resumo: Background and Objectives: Pediatric airway management is a priority during anesthesia, critical care and emergency medicine. The purpose of this study is to validate bedside tests that predict airway management difficulty in anesthetized children. Methods: Children under 12 years of age were recruited in a cross-sectional study to assess the value of some anthropometric measures as predictors of laryngoscopic difficulty. The patients were divided into three groups by age. Weight, height, neck circumference, BMI (body mass index), inter incisors distance thyromental distance, sternomental distance, frontal plane to chin distance (FPCD) and the Mallampati index were determined and were correlated with the CML (Cormack & Lehane classification). Results: The incidence of difficult laryngoscopy (CML 3 or 4) was 3.58%. Factors that were significantly associated with laryngoscopic difficulty included short inter incisors distance, high FPCD, thyromental distance, sternomental distance and the Mallampati index. The FPCD/weight index exhibited a higher area under the ROC curve than any other variable considered. Conclusions: This study confirms that the FPCD and the FPCD/weight ratio are the most consistent predictors of laryngoscopic difficulty in pediatric patients. For patients over 6 months of age, the IID also correlated with laryngoscopic difficulty. For children who were capable of obeying simple orders, the Mallampati test correlated better with laryngoscopic difficulty than did the Mallampati test with phonation.Our results strongly suggest that skilled professionals should perform airway management in children, especially in patients with a high FPCD or a high FPCD/weight ratio.
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spelling Bedside tests to predict laryngoscopic difficulty in pediatric patientsAnesthesiaLaryngoscopyPediatricPredictorsBackground and Objectives: Pediatric airway management is a priority during anesthesia, critical care and emergency medicine. The purpose of this study is to validate bedside tests that predict airway management difficulty in anesthetized children. Methods: Children under 12 years of age were recruited in a cross-sectional study to assess the value of some anthropometric measures as predictors of laryngoscopic difficulty. The patients were divided into three groups by age. Weight, height, neck circumference, BMI (body mass index), inter incisors distance thyromental distance, sternomental distance, frontal plane to chin distance (FPCD) and the Mallampati index were determined and were correlated with the CML (Cormack & Lehane classification). Results: The incidence of difficult laryngoscopy (CML 3 or 4) was 3.58%. Factors that were significantly associated with laryngoscopic difficulty included short inter incisors distance, high FPCD, thyromental distance, sternomental distance and the Mallampati index. The FPCD/weight index exhibited a higher area under the ROC curve than any other variable considered. Conclusions: This study confirms that the FPCD and the FPCD/weight ratio are the most consistent predictors of laryngoscopic difficulty in pediatric patients. For patients over 6 months of age, the IID also correlated with laryngoscopic difficulty. For children who were capable of obeying simple orders, the Mallampati test correlated better with laryngoscopic difficulty than did the Mallampati test with phonation.Our results strongly suggest that skilled professionals should perform airway management in children, especially in patients with a high FPCD or a high FPCD/weight ratio.Department of Anesthesiology Botucatu Medical School UNESPBotucatu Medical School São Paulo State UniversityDepartment of Anesthesiology Botucatu Medical School UNESPBotucatu Medical School São Paulo State UniversityUniversidade Estadual Paulista (Unesp)Mansano, André Marques [UNESP]Módolo, Norma Sueli Pinheiro [UNESP]Silva, Leopoldo Muniz da [UNESP]Ganem, Eliana Maria [UNESP]Braz, Leandro Gobbo [UNESP]Knabe, Andrea de Carvalho [UNESP]Freitas, Fernanda Moreira de [UNESP]2018-12-11T17:01:37Z2018-12-11T17:01:37Z2016-04-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article63-68application/pdfhttp://dx.doi.org/10.1016/j.ijporl.2016.01.031International Journal of Pediatric Otorhinolaryngology, v. 83, p. 63-68.1872-84640165-5876http://hdl.handle.net/11449/17265010.1016/j.ijporl.2016.01.0312-s2.0-849601220802-s2.0-84960122080.pdf7199562550978496Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengInternational Journal of Pediatric Otorhinolaryngology0,783info:eu-repo/semantics/openAccess2024-08-14T13:20:06Zoai:repositorio.unesp.br:11449/172650Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-14T13:20:06Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Bedside tests to predict laryngoscopic difficulty in pediatric patients
title Bedside tests to predict laryngoscopic difficulty in pediatric patients
spellingShingle Bedside tests to predict laryngoscopic difficulty in pediatric patients
Mansano, André Marques [UNESP]
Anesthesia
Laryngoscopy
Pediatric
Predictors
title_short Bedside tests to predict laryngoscopic difficulty in pediatric patients
title_full Bedside tests to predict laryngoscopic difficulty in pediatric patients
title_fullStr Bedside tests to predict laryngoscopic difficulty in pediatric patients
title_full_unstemmed Bedside tests to predict laryngoscopic difficulty in pediatric patients
title_sort Bedside tests to predict laryngoscopic difficulty in pediatric patients
author Mansano, André Marques [UNESP]
author_facet Mansano, André Marques [UNESP]
Módolo, Norma Sueli Pinheiro [UNESP]
Silva, Leopoldo Muniz da [UNESP]
Ganem, Eliana Maria [UNESP]
Braz, Leandro Gobbo [UNESP]
Knabe, Andrea de Carvalho [UNESP]
Freitas, Fernanda Moreira de [UNESP]
author_role author
author2 Módolo, Norma Sueli Pinheiro [UNESP]
Silva, Leopoldo Muniz da [UNESP]
Ganem, Eliana Maria [UNESP]
Braz, Leandro Gobbo [UNESP]
Knabe, Andrea de Carvalho [UNESP]
Freitas, Fernanda Moreira de [UNESP]
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidade Estadual Paulista (Unesp)
dc.contributor.author.fl_str_mv Mansano, André Marques [UNESP]
Módolo, Norma Sueli Pinheiro [UNESP]
Silva, Leopoldo Muniz da [UNESP]
Ganem, Eliana Maria [UNESP]
Braz, Leandro Gobbo [UNESP]
Knabe, Andrea de Carvalho [UNESP]
Freitas, Fernanda Moreira de [UNESP]
dc.subject.por.fl_str_mv Anesthesia
Laryngoscopy
Pediatric
Predictors
topic Anesthesia
Laryngoscopy
Pediatric
Predictors
description Background and Objectives: Pediatric airway management is a priority during anesthesia, critical care and emergency medicine. The purpose of this study is to validate bedside tests that predict airway management difficulty in anesthetized children. Methods: Children under 12 years of age were recruited in a cross-sectional study to assess the value of some anthropometric measures as predictors of laryngoscopic difficulty. The patients were divided into three groups by age. Weight, height, neck circumference, BMI (body mass index), inter incisors distance thyromental distance, sternomental distance, frontal plane to chin distance (FPCD) and the Mallampati index were determined and were correlated with the CML (Cormack & Lehane classification). Results: The incidence of difficult laryngoscopy (CML 3 or 4) was 3.58%. Factors that were significantly associated with laryngoscopic difficulty included short inter incisors distance, high FPCD, thyromental distance, sternomental distance and the Mallampati index. The FPCD/weight index exhibited a higher area under the ROC curve than any other variable considered. Conclusions: This study confirms that the FPCD and the FPCD/weight ratio are the most consistent predictors of laryngoscopic difficulty in pediatric patients. For patients over 6 months of age, the IID also correlated with laryngoscopic difficulty. For children who were capable of obeying simple orders, the Mallampati test correlated better with laryngoscopic difficulty than did the Mallampati test with phonation.Our results strongly suggest that skilled professionals should perform airway management in children, especially in patients with a high FPCD or a high FPCD/weight ratio.
publishDate 2016
dc.date.none.fl_str_mv 2016-04-01
2018-12-11T17:01:37Z
2018-12-11T17:01:37Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1016/j.ijporl.2016.01.031
International Journal of Pediatric Otorhinolaryngology, v. 83, p. 63-68.
1872-8464
0165-5876
http://hdl.handle.net/11449/172650
10.1016/j.ijporl.2016.01.031
2-s2.0-84960122080
2-s2.0-84960122080.pdf
7199562550978496
url http://dx.doi.org/10.1016/j.ijporl.2016.01.031
http://hdl.handle.net/11449/172650
identifier_str_mv International Journal of Pediatric Otorhinolaryngology, v. 83, p. 63-68.
1872-8464
0165-5876
10.1016/j.ijporl.2016.01.031
2-s2.0-84960122080
2-s2.0-84960122080.pdf
7199562550978496
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv International Journal of Pediatric Otorhinolaryngology
0,783
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 63-68
application/pdf
dc.source.none.fl_str_mv Scopus
reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
instacron:UNESP
instname_str Universidade Estadual Paulista (UNESP)
instacron_str UNESP
institution UNESP
reponame_str Repositório Institucional da UNESP
collection Repositório Institucional da UNESP
repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
repository.mail.fl_str_mv
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