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Prediction of difficult laryngoscopy using spirometry: a pilot study.
J Clin Monit Comput. 2017 Dec; 31(6):1115-1121.JC

Abstract

Prediction of difficult laryngoscopy is still the uncovered secret of anesthetic practice. This pilot study is aimed to assess the efficacy of spirometry measurements in predicting difficult laryngoscopy compared with conventional airway assessment techniques. We enrolled 202 adults, ages 18-40 years, with an American Society of Anaesthesiologists score of I or II, scheduled for elective surgery and undergoing general anesthesia. Spirometry was used for lung capacity measurements before the operation. The Mallampati classification, neck circumference, sternomental distance, thyromental distance, maximum mouth-opening measurement, and upper lip bite test of the subjects were measured. During intubation, the Cormack-Lehane grade was recorded. Spearman's correlation analysis was used to define the linearity between spirometry outputs and airway measurements. Receiver operating curves were drawn to discriminate the predictive features of the significant values. The thyromental distance showed a higher correlation with forced inspiratory vital capacity (ρ = 0.420, P < 0.001). In a multivariate linear regression model, all spirometry measurements revealed that forced inspiratory vital capacity (β = -2.050, P = 0.022) was the significant predictor for difficult laryngoscopy. The area under the curve for forced inspiratory vital capacity with a cut-off value of 3.1950 L while using thyromental distance as difficult laryngoscopy indicator is 0.754 and forced inspiratory vital capacity showed a sensitivity of 0.718 and specificity of 0.714 with a positive likelihood ratio of 2.5104 and negative likelihood ratio of 0.3949. Forced inspiratory vital capacity showed a close association with the prediction of difficult laryngoscopy.

Authors+Show Affiliations

Department of Anesthesiology and Reanimation, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey. rightanesthetics@gmail.com.Department of Anesthesiology and Reanimation, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey.Department of Anesthesiology and Reanimation, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey.Department of Anesthesiology and Reanimation, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey.Department of Anesthesiology and Reanimation, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey.Department of Anesthesiology and Reanimation, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey.Department of Anesthesiology and Reanimation, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey.Department of Anesthesiology and Reanimation, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey.Department of Otorhinolaryngology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27866310

Citation

Dogru, Serkan, et al. "Prediction of Difficult Laryngoscopy Using Spirometry: a Pilot Study." Journal of Clinical Monitoring and Computing, vol. 31, no. 6, 2017, pp. 1115-1121.
Dogru S, Karaman T, Sahin A, et al. Prediction of difficult laryngoscopy using spirometry: a pilot study. J Clin Monit Comput. 2017;31(6):1115-1121.
Dogru, S., Karaman, T., Sahin, A., Tapar, H., Karaman, S., Arici, S., Suren, M., Kaya, Z., & Somuk, B. T. (2017). Prediction of difficult laryngoscopy using spirometry: a pilot study. Journal of Clinical Monitoring and Computing, 31(6), 1115-1121. https://doi.org/10.1007/s10877-016-9961-2
Dogru S, et al. Prediction of Difficult Laryngoscopy Using Spirometry: a Pilot Study. J Clin Monit Comput. 2017;31(6):1115-1121. PubMed PMID: 27866310.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of difficult laryngoscopy using spirometry: a pilot study. AU - Dogru,Serkan, AU - Karaman,Tugba, AU - Sahin,Aynur, AU - Tapar,Hakan, AU - Karaman,Serkan, AU - Arici,Semih, AU - Suren,Mustafa, AU - Kaya,Ziya, AU - Somuk,Battal Tahsin, Y1 - 2016/11/19/ PY - 2016/04/20/received PY - 2016/11/14/accepted PY - 2016/11/21/pubmed PY - 2018/7/14/medline PY - 2016/11/21/entrez KW - Airway control KW - Airway management KW - Airway-anatomy KW - Intubation KW - Pulmonary KW - Spirometry SP - 1115 EP - 1121 JF - Journal of clinical monitoring and computing JO - J Clin Monit Comput VL - 31 IS - 6 N2 - Prediction of difficult laryngoscopy is still the uncovered secret of anesthetic practice. This pilot study is aimed to assess the efficacy of spirometry measurements in predicting difficult laryngoscopy compared with conventional airway assessment techniques. We enrolled 202 adults, ages 18-40 years, with an American Society of Anaesthesiologists score of I or II, scheduled for elective surgery and undergoing general anesthesia. Spirometry was used for lung capacity measurements before the operation. The Mallampati classification, neck circumference, sternomental distance, thyromental distance, maximum mouth-opening measurement, and upper lip bite test of the subjects were measured. During intubation, the Cormack-Lehane grade was recorded. Spearman's correlation analysis was used to define the linearity between spirometry outputs and airway measurements. Receiver operating curves were drawn to discriminate the predictive features of the significant values. The thyromental distance showed a higher correlation with forced inspiratory vital capacity (ρ = 0.420, P < 0.001). In a multivariate linear regression model, all spirometry measurements revealed that forced inspiratory vital capacity (β = -2.050, P = 0.022) was the significant predictor for difficult laryngoscopy. The area under the curve for forced inspiratory vital capacity with a cut-off value of 3.1950 L while using thyromental distance as difficult laryngoscopy indicator is 0.754 and forced inspiratory vital capacity showed a sensitivity of 0.718 and specificity of 0.714 with a positive likelihood ratio of 2.5104 and negative likelihood ratio of 0.3949. Forced inspiratory vital capacity showed a close association with the prediction of difficult laryngoscopy. SN - 1573-2614 UR - https://www.unboundmedicine.com/medline/citation/27866310/Prediction_of_difficult_laryngoscopy_using_spirometry:_a_pilot_study_ L2 - https://doi.org/10.1007/s10877-016-9961-2 DB - PRIME DP - Unbound Medicine ER -