• Int. J. Pediatr. Otorhinolaryngol. · Nov 2020

    Randomized Controlled Trial Observational Study

    Evaluation of various anthropometric airway parameters as predictors of difficult airway in neonates: A prospective observational study.

    • Aparna D, Anudeep Jafra, Neerja Bhardwaj, Divya Jain, Ankur Luthra, and Muneer Abas Malik.
    • Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India. Electronic address: aparnadepuru@gmail.com.
    • Int. J. Pediatr. Otorhinolaryngol. 2020 Nov 1; 138: 110387.

    ObjectiveTo determine the relationship between various anthropometric parameters (age, weight, neck circumference, head circumference, thyromental distance, sternomental distance, frontal plane to chin distance, and frontal plane to chin distance by weight ratio) in neonates with difficult laryngoscopy and difficult intubation.DesignA Prospective, double-blind, observational study.SettingConducted in a Tertiary care Hospital in India. The study was conducted over a period of one year.PatientsParticipants included 100 neonates undergoing either elective or emergency non-cardiac surgery under general anesthesia.InterventionsThe various anthropometric parameters were correlated with Difficult laryngoscopy (Cormack Lehane grading III, IV) and Difficult intubation (Intubation Difficulty score>5).MeasurementsDifficult laryngoscopy (Cormack lehane grade III, IV) and Difficult intubation (Intubation Difficulty score >5).Main ResultsWe found a statistically significant difference between weight (2.5 (2.2-2.8) kg vs 1.9 (1.55-2.35) kg), (p = 0.006), TMD (3.03 (2.74-3.46) cm vs 2.70 (2.45-3.13) cm), (p = 0.029), SMD (5.18 (5.06-5.76) cm vs 5.02 (4.84-5.29) cm), (p = 0.020) and FPCD/Wt ratio (0.31 (0.27-0.36) vs 0.44 (0.37-0.44)) with p = 0.001 in neonates with Easy and Difficult laryngoscopy. Using ROC curve analysis we calculated AUC, optimal cut off value, sensitivity, specificity, PPV and NPV for weight, TMD, SMD and FPCD/Wt ratio and found FPCD/Wt ratio to be best predictor for difficult laryngoscopy with highest AUC (0.844), high sensitivity (77.78%) and NPV (97.44%).ConclusionsNo single parameter can provide a high index of sensitivity and specificity to predict difficult airway in neonates. Therefore, a combination of tests, including Weight, TMD, SMD, and FPCD/Wt ratio, should be used. To the best of our knowledge, this is the first prospective study to assess predictors to the difficult airway in neonates.Copyright © 2020 Elsevier B.V. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…