| Poor visualization during direct laryngoscopy and high upper lip bite test score are predictors of difficult intubation with the GlideScope videolaryngoscope. | |
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MedLine Citation:
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PMID: 18420866 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The GlideScope videolaryngoscope allows equal or superior glottic visualization compared with direct laryngoscopy, but predictive features for difficult GlideScope intubation have not been identified. We undertook this prospective study to identify patient characteristics associated with difficult GlideScope intubation. METHODS: Demographic and morphometric factors were recorded preoperatively for 400 patients undergoing anesthesia with endotracheal intubation. After induction, direct laryngoscopy was performed in all patients to assess the Cormack and Lehane grade of glottic visualization followed by GlideScope intubation. The number of attempts and time needed for intubation were recorded. Univariate and multivariate analyses were performed to identify the characteristics associated with difficult GlideScope intubation. RESULTS: Intubation required 1, 2, and 3 attempts in 342, 48, and 9 participants, respectively, with one failure. Mean time for intubation was 21 +/- 14 s. After univariate analysis, the following characteristics were significantly correlated (P < 0.05) with longer time to intubate and/or multiple attempts: older age, male sex, history of snoring, high Mallampati class, small mouth opening, short sternothyroid and manubriomental distances, large neck circumference, high upper lip bite test score, and high Cormack and Lehane grade during direct laryngoscopy. However, after introducing these variables in nominal logistic and proportional hazard multiple regression models, only high Cormack and Lehane grade during direct laryngoscopy, high upper lip bite test score, and short sternothyroid distance were significantly associated with multiple attempts or lengthier intubations. CONCLUSION: Despite a high success rate, intubation with the GlideScope is likely to be more challenging in patients with high Cormack and Lehane grade during direct laryngoscopy, high upper lip bite test score, or short sternothyroid distance. |
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Authors:
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Marie-Hélène Tremblay; Stephan Williams; Arnaud Robitaille; Pierre Drolet |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 106 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-04-18 Completed Date: 2008-05-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 1495-500, table of contents Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, CHUM, Hôpital Notre-Dame, 1560 Sherbrooke East, Montréal, Canada, H2L 4M1. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Equipment Design Female Glottis / anatomy & histology* Humans Intubation, Intratracheal / adverse effects, instrumentation* Jaw Relation Record* Laryngoscopes* Laryngoscopy* Lip Logistic Models Male Middle Aged Neck / anatomy & histology Proportional Hazards Models Prospective Studies ROC Curve Risk Assessment Risk Factors Surgical Procedures, Elective Time Factors Video Recording |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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