TY - JOUR
T1 - Difficult mask ventilation in obese patients
T2 - Analysis of predictive factors
AU - Leoni, A.
AU - Arlati, S.
AU - Ghisi, D.
AU - Verwej, M.
AU - Lugani, D.
AU - Ghisi, P.
AU - Cappelleri, G.
AU - Cedrati, V.
AU - El Tantawi Ali Alsheraei, A.
AU - Pocar, M.
AU - Ceriani, V.
AU - Aldegheri, G.
PY - 2014
Y1 - 2014
N2 - Background. This study aimed to determine the accuracy of commonly used preoperative difficult airway indices as predictors of difficult mask ventilation (DMV) in obese patients (BMI >30 kg/m2). Methods. In 309 consecutive obese patients undergoing general surgery, the modified Mallampati test, patient's Height/Thyromental distance ratio, Inter-Incisor Distance, Protruding Mandible (PM), history of Obstructive Sleep Apnea and Neck Circumference (NC) were recorded preoperatively. DMV was defined as Grade 3 mask ventilation (MV) by the Han's scale (MV inadequate, unstable or requiring two practitioners). Data are shown as means±SD or number and proportions. Independent DMV predictors were identified by multivariate analysis. The discriminating capacity of the model (ROC curve area) and adjusted weights for the risk factors (odds ratios) were also determined. Results. BMI averaged 42.5±8.3 kg/m2. DMV was reported in 27 out of 309 patients (8.8%; 95%CI 5.6-11.9%). The multivariate analysis retained NC (OR 1.17; P2 associated factors as the best discriminating point for DMV. Conclusion. Obese patients show increased incidence of DMV with respect to the undifferentiated surgical population. Limited PM, Mallampati test and NC are important DMV predictors. (Minerva Anestesiol 2014;80:149-57).
AB - Background. This study aimed to determine the accuracy of commonly used preoperative difficult airway indices as predictors of difficult mask ventilation (DMV) in obese patients (BMI >30 kg/m2). Methods. In 309 consecutive obese patients undergoing general surgery, the modified Mallampati test, patient's Height/Thyromental distance ratio, Inter-Incisor Distance, Protruding Mandible (PM), history of Obstructive Sleep Apnea and Neck Circumference (NC) were recorded preoperatively. DMV was defined as Grade 3 mask ventilation (MV) by the Han's scale (MV inadequate, unstable or requiring two practitioners). Data are shown as means±SD or number and proportions. Independent DMV predictors were identified by multivariate analysis. The discriminating capacity of the model (ROC curve area) and adjusted weights for the risk factors (odds ratios) were also determined. Results. BMI averaged 42.5±8.3 kg/m2. DMV was reported in 27 out of 309 patients (8.8%; 95%CI 5.6-11.9%). The multivariate analysis retained NC (OR 1.17; P2 associated factors as the best discriminating point for DMV. Conclusion. Obese patients show increased incidence of DMV with respect to the undifferentiated surgical population. Limited PM, Mallampati test and NC are important DMV predictors. (Minerva Anestesiol 2014;80:149-57).
KW - Anesthesia
KW - Obesity
KW - Ventilation
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M3 - Article
C2 - 24193230
AN - SCOPUS:84898744270
VL - 80
SP - 149
EP - 157
JO - Minerva Anestesiologica
JF - Minerva Anestesiologica
SN - 0375-9393
IS - 2
ER -