Bedside tests to predict laryngoscopic difficulty in pediatric patients
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , |
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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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 |
|
_version_ |
1808128108327337984 |