By Taking Intubation Difficulty Scale As Gold Standard In Assessing Difficult Intubation And Predictive Value Of Restricted Neck Movement

Dr. Salman Hameed, Dr. Jumana Fatima, Dr. Abdul Sami
2018 Zenodo  
The three main causes of respiratory related injuries of anesthesia are inadequate ventilation, esophageal intubation and difficult tracheal intubation. 17% of all respiratory related injuries are due to difficult intubation and it accounts for 28% of anesthesia related deaths'. Airway maintenance during anesthesia is crucial for adequate oxygenation and ventilation and failure to secure airway can lead to tissue hypoxia and ultimately death. Subjects and Methods: This study involved 126
more » ... involved 126 patients of both genders, aged between I8-70 years undergoing general anesthesia with endotracheal intubation on elective lists Difficult intubation was predicted on restricted neck movement (<80°) and was confirmed on IDS. IDS diagnosis was taken as gold standard and results of restricted neck movement were evaluated accordingly. Written informed consent was taken from every patient. Results: The age of the patients ranged from 18 years to 70 years with a mean of 42.49 + 14.56 years. There were 64 (50.8%) male and 62 (49.2%) female patients in the study group. There were 52 (41.3%) obese patients. Difficult intubation was confirmed in 90 (71.4%) patients on intubation difficulty scale (as per operational definition)1. The frequency of difficult intubation was higher among obese patients (80.8% vs. 64.9%; p 0.052) however the difference was insignificant. There were 90 (71.4%) true positive patients with 36 false positive patients. It yielded a positive predictive value of 71.4% for restricted neck movement in the prediction of difficult intubation taking IDS as gold standard. Similar positive predictive value was observed across age, gender and obesity groups. Conclusion: The positive predictive value of restricted neck movement (<80°) was found to be 71.4% in predicting difficult intubation among patients undergoing general anesthesia with endotracheal intubation on elect [...]
doi:10.5281/zenodo.1288747 fatcat:aog5qiejznd4lhhg7j2kx6ripe