• Surendrasingh Chhabada, Chelsea Skinner, Orkun Kopac, Pilar Castro, Edward J Mascha, Dong Wang, Gama de AbreuMarceloMOutcomes Research.Department of Intensive Care and Resuscitation, Cleveland Clinic, Cleveland, Ohio., Alparslan Turan, Daniel I Sessler, and Kurt Ruetzler.
• From the Departments of Pediatric and Congenital Cardiac Anesthesia.
• Anesth. Analg. 2024 Apr 1; 138 (4): 821828821-828.

BackgroundObesity distorts airways and slightly complicates intubations in adults, but whether obesity complicates pediatric intubations remains unclear. We, therefore, tested the primary hypothesis that increasing age- and sex-specific body mass index (BMI) percentile is associated with difficult intubation, defined as >1 intubation attempt.MethodsWe conducted a retrospective analysis of pediatric patients between 2 and 18 years of age who had noncardiac surgery with oral endotracheal intubation. We assessed the association between BMI percentile and difficult intubation, defined as >1 intubation attempt, using a confounder-adjusted multivariable logistic regression model. Secondarily, we assessed whether the main association depended on preoperative substantial airway abnormality status or age group.ResultsA total of 9339 patients were included in the analysis. Median [quartiles] age- and sex-specific BMI percentile was 70 [33, 93], and 492 (5.3%) patients had difficult intubation. There was no apparent association between age- and sex-specific BMI percentile and difficult intubation. The estimated odds ratio (OR) for having difficult intubation for a 10-unit increase in BMI percentile was 0.98 (95% confidence interval [CI], 0.95-1.005) and was consistent across the 3 age groups of early childhood, middle childhood, and early adolescence (interaction P = .53). Patients with preoperative substantial airway abnormalities had lower odds of difficult intubation per 10-unit increase in BMI percentile, with OR (95% CI) of 0.83 (0.70-0.98), P = .01.ConclusionsAge- and sex-specific BMI percentile was not associated with difficult intubation in children between 2 and 18 years of age. As in adults, obesity in children does not much complicate intubation.Copyright © 2023 International Anesthesia Research Society.

24 keywords...

hide…