Difficult intubation in pediatric cardiac anesthesia

Akpek, Elif; Mutlu, Hülya Savaş; Kayhan, Zeynep

doi:10.1053/j.jvca.2004.07.003

Cited by 30 publications

(15 citation statements)

References 17 publications

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“…The incidence of difficult laryngoscopy (Cormack-Lehane laryngoscopic view grade 3 or 4) in our study was 6.14% (47/765), which was quite higher than those reported in previous studies [1,5]. The incidence of difficult intubation in our study was 0.26% (2/765), which was quite lower than those reported in previous studies [3][4]6].…”

Section: Criteria For Diagnosing Difficult Laryngoscopy and Difficultcontrasting

confidence: 64%

“…Reports of difficult laryngoscopy and difficult intubation in pediatric anesthesia varied depending on the criteria used. Some studies reported only difficult laryngoscopy [5], only difficult intubation [3,4], both difficult laryngoscopy and difficult intubation using separate criteria [1], or only difficult intubation using the combined criteria of difficult laryngoscopy and difficult intubation [6]. We used separate criteria to diagnose difficult laryngoscopy and difficult intubation, but we combined both incidence of difficult laryngoscopy and difficult intubation.…”

Section: Criteria For Diagnosing Difficult Laryngoscopy and Difficultmentioning

confidence: 99%

“…The incidence of unexpected difficult laryngoscopy/intubation in children has been reported to vary from 1.2% to 4.8% and is higher in children with congenital heart disease [1,[3][4][5][6]. Predictors of unexpected difficult laryngoscopy/intubation include infancy, associated syndromes or congenital abnormalities, and a diagnosis of obstructive sleep apnea [1,[3][4][5][6][7]. The incidence of unexpected bagmask ventilation (BMV) difficulty in children is around 6.6% [6] which is similar to that reported in adults [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Grading of Bag-Mask Ventilation Difficulty and Association with Unanticipated Difficult Laryngoscopy/Intubation in Children at a Training Center University Hospital: A Prospective Cohort Study

Oofuvong¹,

Sangkaew²,

Nuanjun³

et al. 2020

J Anesth Clin Res

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Objective: In children, the grading of Bag-Mask Ventilation (BMV) difficulty and its association with difficult laryngoscopy/intubation has not been well established. This study aimed to evaluate the grading for BMV difficulty and determine its association with difficult laryngoscopy/intubation in a normal airway pediatric population. Methods: This prospective cohort study was conducted in children aged ≤9 years who underwent general anesthesia and oroendotracheal tube intubation between September 2008 and December 2012. Difficult laryngoscopy was defined as a Cormack-Lehane laryngoscopic view grade of 3 or 4. Difficult intubation was defined as the occurrence of at least two of the following: 1) at least three intubation attempts using direct laryngoscopy by experienced personnel (excluding first intubation attempts); 2) intubation time >300 s; and 3) occurrence of desaturation (SpO 2 <95%). The use of open airway maneuvers, including continuous positive airway pressure (CPAP), oropharyngeal airway (OPA), and two-person ventilation (TPV), or unsuccessful BMV were also considered. The association between BMV difficulty and difficult laryngoscopy/intubation was assessed using multivariate logistic regression with adjusted odds ratios (OR), 95% confidence intervals (CIs), and area under the receiver operating characteristic curve (AUC). Results: The incidence of difficult laryngoscopy/intubation was 6.4% (49/765). The categories of BMV difficulty were grade 0 (easy BMV without requiring an open airway maneuver, n=308), grade 1 (easy BMV after applying CPAP, n=368), grade 2 (successful BMV after inserting an OPA, n=16), grade 3 (successful BMV after applying TPV, n=71), and grade 4 (unsuccessful BMV after applying all airway maneuvers, n=2). Difficult BMV was defined as a BMV grade of 3 or 4 (v/s grades 0-2). After adjusting for age, body weight, history of snoring, type of operation, use of neuromuscular blocking agents, and first laryngoscopist, BMV difficulty was significantly associated with difficult laryngoscopy/intubation (adjusted OR [95% CI]=2.5 [1.1-5.5], sensitivity 0.59, specificity 0.74, AUC=0.70). Conclusion: A BMV grade of 3 (requiring TPV) or 4 (unsuccessful BMV) was associated with difficult laryngoscopy/ intubation in a pediatric population.

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Section: Criteria For Diagnosing Difficult Laryngoscopy and Difficultcontrasting

confidence: 64%

Section: Criteria For Diagnosing Difficult Laryngoscopy and Difficultmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Grading of Bag-Mask Ventilation Difficulty and Association with Unanticipated Difficult Laryngoscopy/Intubation in Children at a Training Center University Hospital: A Prospective Cohort Study

Oofuvong¹,

Sangkaew²,

Nuanjun³

et al. 2020

J Anesth Clin Res

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“…This is a much higher rate of difficult intubation than has been previously reported in children. Studies of children having cardiac surgery and cleft palate repair have reported incidences of difficult laryngoscopy of 1.25% and 4.7% respectively (12,13). In a case series published in 1962, Oliver et al.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic experience of 100 pediatric tracheostomies

Wrightson¹,

Soma

Smith

2009

Pediatric Anesthesia

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“…5,6 Rose ve ark., 18500 erişkin hastada entübe edilemeyip uyandırılan ve cerrahi girişim ertelenen olguların oranını %0,05 olarak bildirirken, Akpek ve ark., kardiyak cerrahi uygulanacak 16 pediatrik olgunun sadece birisinin entübe edilemeyerek uyandırıldı-ğını ve cerrahi girişimin ertelendiğini bildirmişler-dir.…”

Section: Olgu Sunumuunclassified

Intubation with Fiberoptic Bronchoscope, Laryngeal Mask and Intubating Cathater in a Patient with Goldenhar Syndrome: Case Report

Pampal¹,

Demirel²,

Baltaci³

et al. 2015

Turkiye Klinikleri J Case Rep

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irinci ve ikinci brankiyal arkdan köken alan yapıların konjenital defekti sonucu ortaya çıkan Goldenhar sendromu (GS), 3000-5000 canlı doğumda bir görülür.1 Kalıtsal geçişi sporadiktir. 2 Okulo-aurikulovertebral sendrom olarak da bilinen GS fasiyal, kardiyak, renal ve vertebral anomaliler ile karakterizedir. Fasiyal asimetri, fasiyal hipoplazi ve mikrognati gibi fasiyal malformasyonlar ile oksipitalize olmuş atlas ve uzamış odontoid proses gibi vertebral anomalilere bağlı olarak gerek endotrakeal entübasyon gerekse maske ile ventilasyon mümkün olmayabilir.

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Difficult intubation in pediatric cardiac anesthesia

Cited by 30 publications

References 17 publications

Grading of Bag-Mask Ventilation Difficulty and Association with Unanticipated Difficult Laryngoscopy/Intubation in Children at a Training Center University Hospital: A Prospective Cohort Study

Grading of Bag-Mask Ventilation Difficulty and Association with Unanticipated Difficult Laryngoscopy/Intubation in Children at a Training Center University Hospital: A Prospective Cohort Study

Anesthetic experience of 100 pediatric tracheostomies

Intubation with Fiberoptic Bronchoscope, Laryngeal Mask and Intubating Cathater in a Patient with Goldenhar Syndrome: Case Report

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