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Comparison of upper lip bite test and ratio of height to thyromental distance with other airway assessment tests for predicting difficult endotracheal intubation.
Indian J Crit Care Med. 2016 Jan; 20(1):3-8.IJ

Abstract

BACKGROUND

Various anatomical measurements and noninvasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Upper lip bite test (ULBT) and ratio of height to thyromental distance (RHTMD) are claimed to have high predictability. Hence, we have conducted this study to compare the predictive value of ULBT and RHTMD with the following parameters: Mallampati grading, inter-incisor gap, thyromental distance, sternomental distance, head and neck movements, and horizontal length of mandible for predicting difficult intubation.

MATERIALS AND METHODS

In this single blinded, prospective, observational study involving 170 adult patients of either sex belonging to American Society of Anesthesiologists physical Status I-III scheduled to undergo general anesthesia were recruited. All patients were subjected to the preoperative airway assessment and, the above parameters were recorded correlated with Cormack and Lehane grade and analyzed. The number of intubation attempts and use of intubation aids were also noted.

RESULTS

ULBT and RHTMD had highest sensitivity (96.64%, 90.72%), specificity (82.35%, 80.39%), positive predictive value (92.74%, 91.53%), and negative predictive value (91.3%, 78.8%), respectively, compared to other parameters. While odds ratio and likelihood ratio >1 for all the tests.

CONCLUSION

ULBT can be used as a simple bedside screening test for prediction of difficult intubation, but it should be combined with other airway assessment tests for better airway predictability. RHTMD can also be used as an acceptable alternative.

Authors+Show Affiliations

Department of Anesthesiology, P. D. U. Medical College, Rajkot, Gujarat, India.Department of Anesthesiology, P. D. U. Medical College, Rajkot, Gujarat, India.Department of Anesthesiology, P. D. U. Medical College, Rajkot, Gujarat, India.Department of Anesthesiology, P. D. U. Medical College, Rajkot, Gujarat, India.Department of Anesthesiology, P. D. U. Medical College, Rajkot, Gujarat, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26955210

Citation

Badheka, Jigisha Prahladrai, et al. "Comparison of Upper Lip Bite Test and Ratio of Height to Thyromental Distance With Other Airway Assessment Tests for Predicting Difficult Endotracheal Intubation." Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, vol. 20, no. 1, 2016, pp. 3-8.
Badheka JP, Doshi PM, Vyas AM, et al. Comparison of upper lip bite test and ratio of height to thyromental distance with other airway assessment tests for predicting difficult endotracheal intubation. Indian J Crit Care Med. 2016;20(1):3-8.
Badheka, J. P., Doshi, P. M., Vyas, A. M., Kacha, N. J., & Parmar, V. S. (2016). Comparison of upper lip bite test and ratio of height to thyromental distance with other airway assessment tests for predicting difficult endotracheal intubation. Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, 20(1), 3-8. https://doi.org/10.4103/0972-5229.173678
Badheka JP, et al. Comparison of Upper Lip Bite Test and Ratio of Height to Thyromental Distance With Other Airway Assessment Tests for Predicting Difficult Endotracheal Intubation. Indian J Crit Care Med. 2016;20(1):3-8. PubMed PMID: 26955210.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of upper lip bite test and ratio of height to thyromental distance with other airway assessment tests for predicting difficult endotracheal intubation. AU - Badheka,Jigisha Prahladrai, AU - Doshi,Pratik M, AU - Vyas,Ashutosh M, AU - Kacha,Nirav Jentilal, AU - Parmar,Vandana S, PY - 2016/3/9/entrez PY - 2016/3/10/pubmed PY - 2016/3/10/medline KW - Airway assessment tests KW - difficult laryngoscopy KW - ratio of height to thyromental distance KW - upper lip bite tests SP - 3 EP - 8 JF - Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine JO - Indian J Crit Care Med VL - 20 IS - 1 N2 - BACKGROUND: Various anatomical measurements and noninvasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Upper lip bite test (ULBT) and ratio of height to thyromental distance (RHTMD) are claimed to have high predictability. Hence, we have conducted this study to compare the predictive value of ULBT and RHTMD with the following parameters: Mallampati grading, inter-incisor gap, thyromental distance, sternomental distance, head and neck movements, and horizontal length of mandible for predicting difficult intubation. MATERIALS AND METHODS: In this single blinded, prospective, observational study involving 170 adult patients of either sex belonging to American Society of Anesthesiologists physical Status I-III scheduled to undergo general anesthesia were recruited. All patients were subjected to the preoperative airway assessment and, the above parameters were recorded correlated with Cormack and Lehane grade and analyzed. The number of intubation attempts and use of intubation aids were also noted. RESULTS: ULBT and RHTMD had highest sensitivity (96.64%, 90.72%), specificity (82.35%, 80.39%), positive predictive value (92.74%, 91.53%), and negative predictive value (91.3%, 78.8%), respectively, compared to other parameters. While odds ratio and likelihood ratio >1 for all the tests. CONCLUSION: ULBT can be used as a simple bedside screening test for prediction of difficult intubation, but it should be combined with other airway assessment tests for better airway predictability. RHTMD can also be used as an acceptable alternative. SN - 0972-5229 UR - https://www.unboundmedicine.com/medline/citation/26955210/Comparison_of_upper_lip_bite_test_and_ratio_of_height_to_thyromental_distance_with_other_airway_assessment_tests_for_predicting_difficult_endotracheal_intubation_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/26955210/ DB - PRIME DP - Unbound Medicine ER -
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