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Predictors of difficult intubation when using a videolaryngoscope with an intermediate-angled blade during the first attempt: a prospective observational study

Authors
 Hye Jin Kim 1, Hye Rim Kim 2, So Yeon Kim 1, Ha Yan Kim 2, Wyun Kon Park 1, Min Ho Lee 1, Hyun Joo Kim 
Citation
 JOURNAL OF CLINICAL MONITORING AND COMPUTING, Vol.36(4) : 1121-1130, 2022-08 
Journal Title
JOURNAL OF CLINICAL MONITORING AND COMPUTING
ISSN
 1387-1307 
Issue Date
2022-08
MeSH
Anesthesia, General ; Female ; Humans ; Intubation, Intratracheal / methods ; Laryngoscopes* ; Laryngoscopy* / methods ; Male ; Prospective Studies ; Video Recording
Keywords
Airway assessment ; Predictor difficult intubation ; Time factors ; Videolaryngoscope
Abstract
The curvature of a videolaryngoscope blade has been diversified from the standard macintosh-type to the hyperacute-angle-type, resulting in different performances. We aimed to determine the intubation success rate and identify predictors of difficult intubation when using an intermediate-angled videolaryngoscope in the first attempt of intubation under routine anaesthesia settings. We enrolled 808 patients between 19 and 79 years of age, scheduled for elective surgeries under general anaesthesia with orotracheal intubation from July 2017 to November 2018; patients who were candidates for awake intubation were excluded. We obtained patient demographic data and performed airway evaluation before induction of anaesthesia for elective surgeries. We used the UEScope for tracheal intubation with a hockey stick-shaped malleable stylet. The intubation time was defined as the total duration from the entry of the blade into the oropharynx to the detection of first end-tidal carbon dioxide capnogram; this duration was recorded along with the number of intubation attempts. Difficult intubation was defined as either > 60 s duration for tracheal intubation, or > 1 intubation attempt. The use of the UEScope demonstrated a 99.4% success rate for intubation; however, increased difficulties were observed in patients who were male, obese, had a short thyromental distance, limited mouth opening, and high upper-lip-bite test class. Despite the high intubation success rate using an intermediate-angled videolaryngoscope, we recommend preparing backup plans, considering the increased difficulty in patients with certain preoperative features.Clinical trial number and registry URL: Clinical Trials.gov Identifier: NCT03215823 (Date of registration: 12 July).
Full Text
https://link.springer.com/article/10.1007/s10877-021-00742-9
DOI
10.1007/s10877-021-00742-9
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Kim, Ha Yan(김하얀)
Kim, Hyun Joo(김현주) ORCID logo https://orcid.org/0000-0003-1963-8955
Kim, Hye Jin(김혜진) ORCID logo https://orcid.org/0000-0003-3452-477X
Park, Wyun Kon(박윤곤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189531
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