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USE OF PREDICTIVE EL-GANZOURI SCORE IN EVALUATION OF DIFFICULT AIRWAY IN OBESE PATIENTS

https://doi.org/10.21292/2078-5658-2018-15-2-38-44

Abstract

The frequency of difficult laryngoscopy and tracheal intubation in obese patients is higher compared to non-obese patients. Therefore it is important to perform an adequate assessment of airway before surgery with general anesthesia and tracheal intubation in such patients. This retrospective study evaluated the predictive value of El-Ganzouri score in the patients with body weight index exceeding 30 kg/sq. m.

Subjects and methods. 116 patients were enrolled into the study, general anesthesia with tracheal intubation was planned in all those patients. The airway of all patients was assessed by El-Ganzouri score prior to surgery. Regardless of the number of scores in a patient, a video laryngoscope was always used, however by the first intubation attempt it was used as a regular one.

Results. The score sensitivity made 0.81, specificity – 0.66, positive predictability – 0.4, negative predictability – 0.93. The area under ROC-curve made 0.82.

Conclusions. We recommend El-Ganzouri score for evaluation of airway in the patients with BMI exceeding 30 kg/sq. m. since it possesses good modeling properties (AUC = 0.85) and allows selecting the safest way of intubation.

About the Authors

A. A. Klimov
A. S. Loginov Moscow Clinical Scientific Center, Moscow Health Department
Russian Federation

Andrey A. Klimov – Anesthesiologist and Emergency Physician of Anesthesiology and Intensive Care Center

86, Entuziastov Highway, Moscow, 111123



A. A. Mаlаkhovа
A. S. Loginov Moscow Clinical Scientific Center, Moscow Health Department
Russian Federation

Anna A. Malakhova Anesthesiologist and Emergency Physician of Anesthesiology and Intensive Care Center

86, Entuziastov Highway, Moscow, 111123



S. А. Kаmnev
A. S. Loginov Moscow Clinical Scientific Center, Moscow Health Department
Russian Federation

Sergey A. Kamnev – Anesthesiologist and Emergency Physician of Anesthesiology and Intensive Care Center

86, Entuziastov Highway, Moscow, 111123



V. V. Subbotin
A. S. Loginov Moscow Clinical Scientific Center, Moscow Health Department
Russian Federation

Valery V. Subbotin – Doctor of Medical Sciences, Head of Anesthesiology and Intensive Care Center

86, Entuziastov Highway, Moscow, 111123



References

1. Aiello G., Metcalf I. Anaesthetic implications of temporomandibular joint disease. Can. J. Anaesth., 1992, vol. 39, pp. 610-616.

2. Arne J., Descoins P., Fusciardi J. et al. Preoperative assessment for difficult intubation in general and ENT surgery: Predictive value of a clinical multivariate risk index. Br. J. Anaesth., 1998, vol. 80, pp. 140-146.

3. Benumof J.L. Management of the difficult adult airway. Anesthesiology, 1991, vol. 75, pp. 1087-1110.

4. Cook T.M., Woodall N., Frerk C. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br. J. Anaesth., 2011, vol. 106, pp. 617-631.

5. Cuchillo J.V., Rodriguez M.A. Considerations aimed at facilitating the use of the new Glide Scopevideolaryngoscope. Can. J. Anaesth., 2005, vol. 52, pp. 661.

6. de Jong A., Molinari N., Pouzeratte Y. et al. Difficult intubation in obese patients: incidence, risk factors, and complications in the operating theatre and in intensive care units. Br. J. Anaesth., 2015, vol. 114, no. 2, pp. 297-306.

7. El-Ganzouri A.R., McCarthy R.J., Tuman K.J. et al. Preoperative airway assessment: predictive value of a multivariate risk index. Anesth. Analg., 1996, vol. 82, pp. 1197-1204.

8. Kramer D.C., Osborn I.P. More maneuvers to facilitate tracheal intubation with the GlideScope. Can. J. Anaesth., 2006, vol. 53, pp. 737.

9. http://www.who.int/mediacentre/factsheets/fs311/ru/

10. Lee A., Fan L.T., Gin T. et al. A systematic review (meta-analysis) of the accuracy of the Mallampati tests to predict the difficult airway. Anesth. Analg., 2006, vol. 102, pp. 1867-1878.

11. Lundstrоm L.H., Moller A.M., Rosenstock C. et al. High body mass index is a weak predictor for difficult and failed tracheal intubation: a cohort study of 91,332 consecutive patients scheduled for direct laryngoscopy registered in the Danish Anesthesia Database. Anesthesiology, 2009, vol. 110, no. 2, pp. 266-274.

12. Mallampati S.R., Gatt S.P., Gugino L.D. et al. A clinical sign to predict difficult tracheal intubation: A prospective study. Can. Anaesth. Soc. J., 1985, vol. 32, pp. 429-434.

13. Oates J.D., Macleod A.D., Oates P.D. et al. Comparison of two methods for predicting difficult intubation. Br. J. Anaesth., 1991, vol. 66, pp. 305-309.

14. Peterson G.N., Domino K.B., Caplan R.A. et al. Management of the difficult airway: a closed claims analysis. Anesthesiology, 2005, vol. 103, pp. 33-39.

15. Practice guidelines for management of the difficult airway. A report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology, 1993, vol. 78, pp. 597-602.

16. Uribe A.A., Zvara D.A., Puente E.G. et al. BMI as a Predictor for Potential Difficult Tracheal Intubation in Males. Front Med. (Lausanne), 2015, vol. 4, pp. 2-38.

17. Rose D.K., Cohen M.M. The airway: problems and predictions in 18,500 patients. Can. J. Anaesth., 1994, vol. 41, no. 5, pp. 372-383.

18. Samsoon G.L., Young J.R. Difficult tracheal intubation: A retrospective study. Anaesthesia, 1987, vol. 42, pp. 487-490.

19. Societe Francaised'Anesthesieet de Reanimation: Intubation difficile. Ann. Fr. Anesth. Reanim., 1996, vol. 15, pp. 207-214.

20. Tse J.C., Rimm E.B., Hussain A. Predicting difficult endotracheal intubation in surgical patients scheduled for general anesthesia: A prospective blind study. Anesth. Analg., 1995, vol. 81, pp. 254-258.

21. Turkan S., Ateş Y., Cuhruk H. et al. Should we reevaluate the variables for predicting the difficult airway in anesthesiology? Anesth. Analg., 2002, vol. 94, pp. 1340-1344.

22. Wilson M.E., Spiegelhalter D., Robertson J.A. et al. Predicting difficult intubation. Br. J. Anaesth., 1988, vol. 61, pp. 211-216.

23. Yentis S.M. Predicting difficult intubation − worthwhile exercise or pointless ritual? Anaesthesia, 2002, vol. 57, pp. 105-109.


Review

For citations:


Klimov A.A., Mаlаkhovа A.A., Kаmnev S.А., Subbotin V.V. USE OF PREDICTIVE EL-GANZOURI SCORE IN EVALUATION OF DIFFICULT AIRWAY IN OBESE PATIENTS. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2018;15(2):38-44. (In Russ.) https://doi.org/10.21292/2078-5658-2018-15-2-38-44



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