Can point-of-care ultrasound predict the difficulty in intubation? - A prospective observational study.

IF 1.9 Q1 ANESTHESIOLOGY
Indian Journal of Anaesthesia Pub Date : 2025-04-01 Epub Date: 2025-03-13 DOI:10.4103/ija.ija_1066_24
Roopali Phulli, Samarjit Dey, Indubala Maurya, Praveen K Neema, Habib Md Reazaul Karim, H N Lohith Kumar
{"title":"Can point-of-care ultrasound predict the difficulty in intubation? - A prospective observational study.","authors":"Roopali Phulli, Samarjit Dey, Indubala Maurya, Praveen K Neema, Habib Md Reazaul Karim, H N Lohith Kumar","doi":"10.4103/ija.ija_1066_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Airway ultrasonography (USG) parameters have been used to predict difficult tracheal intubation. However, the available literature on this topic is still controversial. This study aims to assess the role of preoperative airway USG parameters, namely hyomental distance in the head neutral (HMDn), head extended position (HMDe) and their ratio (HMDR), pre-epiglottic space (PreE), and the distance from the epiglottis to the vocal cords midpoint (E-VC) and their ratio (PreE/E-VC), in predicting difficult intubation.</p><p><strong>Methods: </strong>This prospective observational study was conducted on 190 patients. Preoperative USG airway parameters were measured. The primary outcome was to correlate these USG parameters with the Cormack-Lehane (CL) grade. The secondary outcome was to correlate these USG parameters with the intubation difficulty score (IDS). Kendall's tau correlation test and receiver operating characteristic curve analysis were performed.</p><p><strong>Results: </strong>A positive correlation was observed between PreE/E-VC ratio and CL grade [Kendall's tau: 0.423 (95% confidence interval (CI): 0.326, 0.513; <i>P</i> < 0.0001], while HDMR showed a non-significant correlation with CL grade [Kendall's tau: -0.0614 (95%CI: -0.183, 0.0569); <i>P</i> = 0.211]. PreE/E-VC ratio also showed a positive correlation with IDS [Kendall's tau: 0.391 (95%CI: 0.305, 0.471); <i>P</i> = <0.0001), while HDMR did not show any correlation with IDS [Kendall's tau: -0.0405 (95%CI: -0.174, 0.084); <i>P</i> = 0.409]. PreE/E-VC ratio >1.61 cm had 77.8% sensitivity and specificity of 86% to predict CL grade >2, while ratio >1.18 cm had a sensitivity of 71.7% and specificity of 76.4% to predict IDS ≥1.</p><p><strong>Conclusion: </strong>The USG measurement of the PreE/E-VC ratio correlated with CL grade and IDS, while HMDR poorly correlated with CL grade and IDS and thus failed to predict difficult intubation.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"372-379"},"PeriodicalIF":1.9000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275219/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Anaesthesia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ija.ija_1066_24","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/13 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background and aims: Airway ultrasonography (USG) parameters have been used to predict difficult tracheal intubation. However, the available literature on this topic is still controversial. This study aims to assess the role of preoperative airway USG parameters, namely hyomental distance in the head neutral (HMDn), head extended position (HMDe) and their ratio (HMDR), pre-epiglottic space (PreE), and the distance from the epiglottis to the vocal cords midpoint (E-VC) and their ratio (PreE/E-VC), in predicting difficult intubation.

Methods: This prospective observational study was conducted on 190 patients. Preoperative USG airway parameters were measured. The primary outcome was to correlate these USG parameters with the Cormack-Lehane (CL) grade. The secondary outcome was to correlate these USG parameters with the intubation difficulty score (IDS). Kendall's tau correlation test and receiver operating characteristic curve analysis were performed.

Results: A positive correlation was observed between PreE/E-VC ratio and CL grade [Kendall's tau: 0.423 (95% confidence interval (CI): 0.326, 0.513; P < 0.0001], while HDMR showed a non-significant correlation with CL grade [Kendall's tau: -0.0614 (95%CI: -0.183, 0.0569); P = 0.211]. PreE/E-VC ratio also showed a positive correlation with IDS [Kendall's tau: 0.391 (95%CI: 0.305, 0.471); P = <0.0001), while HDMR did not show any correlation with IDS [Kendall's tau: -0.0405 (95%CI: -0.174, 0.084); P = 0.409]. PreE/E-VC ratio >1.61 cm had 77.8% sensitivity and specificity of 86% to predict CL grade >2, while ratio >1.18 cm had a sensitivity of 71.7% and specificity of 76.4% to predict IDS ≥1.

Conclusion: The USG measurement of the PreE/E-VC ratio correlated with CL grade and IDS, while HMDR poorly correlated with CL grade and IDS and thus failed to predict difficult intubation.

即时超声能预测插管困难吗?-前瞻性观察性研究。
背景与目的:气道超声(USG)参数已被用于预测气管插管困难。然而,关于这一主题的现有文献仍然存在争议。本研究旨在评估术前气道USG参数,即头中性位置(HMDn)、头伸展位置(HMDe)及其比值(HMDR)、会阴前间隙(PreE)、会阴到声带中点的距离(E-VC)及其比值(PreE/E-VC)在预测插管困难中的作用。方法:对190例患者进行前瞻性观察性研究。测量术前USG气道参数。主要结果是将USG参数与Cormack-Lehane (CL)等级相关联。次要结果是这些USG参数与插管困难评分(IDS)的相关性。进行Kendall's tau相关检验和受试者工作特征曲线分析。结果:PreE/E-VC比值与CL分级呈正相关[Kendall's tau: 0.423(95%可信区间(CI): 0.326, 0.513;P < 0.0001],而HDMR与CL分级无显著相关[Kendall's tau: -0.0614 (95%CI: -0.183, 0.0569);P = 0.211]。PreE/E-VC比值也与IDS呈正相关[Kendall's tau: 0.391 (95%CI: 0.305, 0.471);P = P = 0.409]。PreE/E-VC比值>1.61 cm预测CL级>2的敏感性为77.8%,特异性为86%,比值>1.18 cm预测IDS≥1的敏感性为71.7%,特异性为76.4%。结论:USG测量PreE/E-VC比值与CL分级和IDS相关,而HMDR与CL分级和IDS相关性较差,无法预测插管困难。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
4.20
自引率
44.80%
发文量
210
审稿时长
36 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信