Predicting difficulties in Mask Ventilation using Machine Learning techniques

Sreekantha, D. K.; Saldanha, Roline Stapny; Krishnappa, Jotsna Gowda; Mehandale, Sripada G.; Glen, Rodrigues Rhea Carmel; Prajna, MK

doi:10.1109/discover47552.2019.9008092

Cited by 3 publications

(8 citation statements)

References 11 publications

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“…In previous studies, it has been proven that the number of remained dentate decreased when people become older and older, and the elderly also had higher proportion of becoming completely edentulous (41,42), our GAP analysis also found the same trend, the variables of age and lack of teeth were moderately correlated. Besides, the moderately correlation of sunken cheeks and di cult mask ventilation can also be shown by GAP analysis, which matches the result of previous studies, sunken cheeks was found to independently identify di cult mask ventilation (43,44), so by the above two associations, this visualization tool is reasonable and reliable. However, we found sunken cheeks was a predictor of non-di cult endotracheal intubation in this study, it may imply less intubation resistant from facial muscle.…”

Section: Discussionsupporting

confidence: 88%

A Predictive Formula for Difficult Endotracheal Intubation in the Emergency Department

Liao

Chang

et al. 2020

Preprint

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Background Current predictors for evaluating difficult endotracheal intubation had poor accessibility or sensitivity at the emergency department, so we evaluated the incidence and predictive factors, then built an easy-to-use predictive formula.Methods For the 110 patients, difficult airway was defined as Cormack & Lehane classification grade III and IV at first attempt of intubation. The univariate associations between patient characteristics and difficult endotracheal intubation were then analyzed, and the significantly associated factors were included in a multivariate binary logistic regression model then a predictive formula was generated. Generalized association plot (GAP) was used to show the relationship between each variables.Results The incidence of difficult intubation in our study was 35.5%. In the difficult airway group, significantly higher rates (p<0.05) of high body mass index (BMI); double chin; thick, short neck; Mallampati difficulty; smaller inter-incisors distance; smaller thyromental distance; and upper airway obstruction were noted. Finally, a predictive formula for difficult intubation was successfully established by the combination of four predictors: BMI (odds ratio [OR]=1.270), thyromental distance (OR=0.614), upper airway obstruction (OR=4.038), and Mallampati difficulty (OR=5.163). A cut-off score of 4 provided the best sensitivity (79.5%) and specificity (81.7%)(95% CI: 0.794 to 0.938).Conclusions Our predictive formula could be used by emergency physicians to quickly identify and carefully manage patients with potentially difficult intubation. Early expert consultation could be sought when necessary.Trial registration This 17-month (2011/11/1-2013/3/31) prospective observational study was approved by the Institutional Review Board of MacKay Memorial Hospital (11MMHISO64).

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Section: Discussionsupporting

confidence: 88%

A Predictive Formula for Difficult Endotracheal Intubation in the Emergency Department

Liao

Chang

et al. 2020

Preprint

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“…For NuMask the most significant risk factor was BMI and the other was mallampati score. Our results are compatible with a number of risk factors in studies involving a larger number of patients for classic mask 3,9 and additionally determines risk factors for intraoral mask.…”

Section: Discussionsupporting

confidence: 87%

“…The main difference of our study from others 12,13,15,17,22 is that it was performed on real patients under operating room conditions and both masks were used in a large series of patients. Although there are many studies investigating the risk factors for difficult mask ventilation in the literature 3,8,9 , to our knowledge our study is the first study investigating these risk factors for intraoral mask together with the classic mask in the same patient group. Since we have a large patient series, we were able to secondarily investigate the predictors of difficult mask ventilation for both of the masks.…”

Section: Discussionmentioning

confidence: 95%

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Comparison of intra-oral mask and classic face mask in terms of ventilation success and practitioners’ work load assessments: a randomized crossover study

Alkan

Aytaç

et al. 2021

Preprint

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Aim: Providing effective ventilation of the unconscious patient is an essential skill in every specialty dealing with airway management. In this randomized cross-over study aimed to compare intra-oral and classic face mask in terms of ventilation success of patients, practitioners’ workload and anxiety assessments. Also we analyzed potential risk factors of difficult mask ventilation for both masks. Methods: 24 anesthesiology residents and 12 anesthesiologists participated in the study. Each of the practitioners ventilated 4 patients with both masks at settled pressure and frequency. Practitioners rated their workload and anxiety related to masks with National Aeronautics and Space Administration Task Load Index score and State Trait Anxiety Inventory scale. Ventilation success was evaluated with Han scale, expiratory tidal volume and leak volume. We analyzed potential risk factors of difficult mask ventilation with anthropometric characteristics and STOP-BANG score. Results: Ventilation success rate was superior with intraoral mask comparing to classic face mask in terms of Han Scale (Easy mask ventilation percentage 84/144 (58.3%); 123/144 (85.4%); respectively) and tidal volume (481.92±173.99; 430.85±154.87mL; respectively). Leak volume in intraoral mask ventilation was significantly lower than classic face mask (71.50±91.17 /159.38±146.31 respectively). Diffucult mask ventilation risk factors were high weight, neck circumference, Mallampati score and STOP-BANG score>3 for classic face mask (at the utmost neck circumference 95% CI, OR=1.180, p= 0.002) Risk factors were high body mass index and Mallampati score for intraoral mask (at the utmost Body mass index 95% CI, OR=1.162 p=0.006). The anxiety ratings of practitioners were similar between two masks. The work-load rating is higher with intraoral mask comparing to classic face mask. Conclusion: Intraoral mask may be an effective alternative device for bag-valve mask ventilation.

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“…The main difference of our study from others 12,13,15,17,22 is that it was performed on real patients under operating room conditions and both masks were used in a large series of patients. Although there are many studies investigating the risk factors for difficult mask ventilation in the literature, 3,4,9 to our knowledge our study is the first study investigating these risk factors for intraoral mask together with the classic mask in the same patient group. Since we have a large patient series, we were able to secondarily investigate the predictors of difficult mask ventilation for both of the masks.…”

Section: Ta B L Ementioning

confidence: 94%

Comparison of intraoral mask and classic face mask in terms of ventilation success and practitioners' workload assessments: A randomised crossover study

Alkan

Aytaç

et al. 2021

Int J Clin Pract

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Providing effective ventilation of the unconscious patient during either resuscitation or general anaesthesia induction and wake-up period is an essential skill in every specialty dealing with airway management. Adequate mask ventilation has become an important focus in the difficult airway algorithms' various stages. 1,2 Although mask ventilation is life-saving and important, this topic has been given little coverage in the widespread scientific literature and book chapters on airway management. 3 Determining risk factors

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Predicting difficulties in Mask Ventilation using Machine Learning techniques

Cited by 3 publications

References 11 publications

A Predictive Formula for Difficult Endotracheal Intubation in the Emergency Department

A Predictive Formula for Difficult Endotracheal Intubation in the Emergency Department

Comparison of intra-oral mask and classic face mask in terms of ventilation success and practitioners’ work load assessments: a randomized crossover study

Comparison of intraoral mask and classic face mask in terms of ventilation success and practitioners' workload assessments: A randomised crossover study

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