Assessment of anaesthetists’ ability to predict difficulty of bag-mask ventilation

Roberts, S. B.; Cyna, Allan M; Walsh, J.; Davis, Joel

doi:10.1093/bja/aet324

Cited by 4 publications

(1 citation statement)

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“…Recent investigations have demonstrated that the incidence and risk factors for DMV are distinct from difficult laryngoscopy (DL) predictors (incidence i.e. ranges from 1.4% 8 to 16% 9 ). There are many reasons that can explain these findings: (1) absence of a universally accepted definition of DMV (different definitions lead to different data); (2) obesity and OSA are undoubtedly predictors of DMV, therefore a study done on a population with a high prevalence of obesity will show a higher incidence of DMV from a population with a lower prevalence of obesity; (3) the design of face masks and the technique used are not usually reported, but recent studies highlight their importance for performance and accordingly the reported incidence of DMV 10 , 11 ; (4) the influence of neuromuscular block on mask ventilation has been demonstrated, but often these data are missing 12 .…”

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confidence: 99%

Difficult mask ventilation in general surgical population: observation of risk factors and predictors

Cattano¹,

Killoran²,

Cai

et al. 2014

F1000Res

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Background: There are few predictors of difficult mask ventilation and a simple, objective, predictive system to identify patients at risk of difficult mask ventilation does not currently exist. We present a retrospective - subgroup analysis aimed at identifying predictive factors for difficult mask ventilation (DMV) in patients undergoing pre-operative airway assessment before elective surgery at a major teaching hospital. Methods: Data for this retrospective analysis were derived from a database of airway assessments, management plans, and outcomes that were collected prospectively from August 2008 to May 2010 at a Level 1 academic trauma center. Patients were stratified into two groups based on the difficulty of mask ventilation and the cohorts were analyzed using univariate analysis and stepwise selection method. Results: A total of 1399 pre-operative assessments were completed with documentation stating that mask ventilation was attempted. Of those 1399, 124 (8.9%) patients were found to be difficult to mask ventilate. A comparison of patients with and without difficult mask ventilation identified seven risk factors for DMV: age, body mass index (BMI), neck circumference, history of difficult intubation, presence of facial hair, perceived short neck and obstructive sleep apnea. Although seven risk factors were identified, no individual subject had more than four risk factors. Conclusion: The results of this study confirm that in a real world clinical setting, the incidence of DMV is not negligible and suggest the use of a simple bedside predictive score to improve the accuracy of DMV prediction, thereby improving patient safety. Further prospective studies to validate this score would be useful.

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