2015, Number 5
<< Back Next >>
Gac Med Mex 2015; 151 (5)
Diagnostic utility of the hyomental distance ratio as predictor of difficult intubation at UMAE 25
Montemayor-Cruz JM, Guerrero-Ledezma RM
Language: Spanish
References: 34
Page: 599-607
PDF size: 85.77 Kb.
ABSTRACT
Background: The hyomental distance ratio is defined as the ratio of the hyomental distances in neutral position and at
head extension. The aim of the study was to establish the diagnostic utility as predictor of difficult intubation.
Methods: In
a cross-sectional study, the assessment of the airway was performed in 70 patients (35 male and 35 female, 15-75 years
old) undergoing general anesthesia with endotracheal intubation for elective surgery. We assessed Mallampati, Patil Aldreti,
interincisive distance, Bellhouse Doré scales and hyomental distance ratio. Subsequently, laryngoscopy was performed and
the view graded with Cormack scale. We define “difficult intubation” as Cormack III and IV. We determined the diagnostic utility
of the scales and the hyomental distance ratio.
Results: For hyomental distance ratio of ≤ 1.2 we calculated sensitivity, 60%;
specificity, 20%; positive predictive value, 5%; negative predictive value, 86%; positive likelihood ratio of 0.75 and negative
likelihood ratio of 2.
Conclusions: The hyomental distance ratio, as predictor of difficult intubation, has little utility.
REFERENCES
Covarrubias A, Martínez JL, Reynada JL. Actualidades en la vía aérea difícil. Rev Mex Anest. 2004;27:210-8.
Folch. Diccionario Enciclopédico University de Términos Médicos. Mc- Graw-Hill; 1981.
Rh Value Publishing. Webster’s Universal College Dictionary. Gramercy; 1997.
Practice guidelines for the management of the difficult airway. American Society of Anesthesiologist Task Force on Management of the Difficult Airway. Anesthesiology. 1993;78:597-602.
Practice guidelines for the management of the difficult airway. An updated report by the American Society of Anesthesiologist Task Force on management of the difficult airway. Anesthesiology. 2003;98:1269-77.
Butler KH. Management of the difficult airway: alternative airway techniques and adjuncts. Emerg Med Clin North Am. 2003;23:259-89.
Euliano T, Lee A. Development and evaluation of an Internet based Airway evaluation tutorial. Med Educ Online. 2003;8:18.
Koppel J, Reed A. Formal instruction in difficult airway management: A survey of anesthesiology resident programs. Anesthesiology. 1995;83: 1343-6.
Benumof JL. The ASA difficult airway algorithm: New thoughts/considerations in ASA Annual refresher course lectures. 1998;236.
Higgings LF. Clasificaciones predictivas para intubación difícil. Anestesiología Mexicana en Internet. Disponible en: www.anestesia.com.mx. 2004.
Levitan R, Dickinson E. Assessing Mallampati scores, thyromentonial distance, and neck mobility in Emergency Department intubated patients. Acad Emerg Med. 2003;10:468.
Calder I, Pichard J. Mouth opening: A new angle. Anesthesiology. 2003; 99:799-801.
Tamura M, Ishikawa T. Mandibular advancement improves the laryngeal view during direct laryngoscopy performed by inexperienced physicians. Anesthesiology. 2004;100:598-601.
Eberhart LH, Arndt C, Cierpka T, et al. The reliability and validity of the upper lip bite test compared with the Mallampati classification to predict difficult laryngoscopy: an external prospective evaluation. Anesth Analg. 2005;101:284-9.
Mallampati SR. A clinical sign to predict difficult tracheal intubation: A prospective study. Can Anaesth Soc J. 1985;32:429-34.
Samsoon GL, Young JR. Difficult tracheal intubation. Anaesthesia. 1987;42:487-90.
Shiga T, Wajima Z, Inoue T, et al. Predicting Difficult Intubation in Apparently Normal Patients: a meta-analysis of Bedside Screening Test Performance. Anesthesiology. 2005;103:429-37.
Mace SE. Challenges and advances in intubation: airway evaluation and controversies with intubation. Emerg Med Clin N Am. 2008;26: 977-1000.
Dargin J, Medzon R. Emergency Department Management of the Airway in Obese Adults. Ann Emerg Med. 2010;56:95-104.
Orozco-Díaz E, Álvarez-Ríos JJ, Arceo-Díaz JL, et al. Predicción de intubación difícil mediante escalas de valoración de la vía aérea. Cir Cir. 2010;78:393-9.
Wilson ME, Spiegelhalter D. Predicting difficult intubation. Br J Anaesth. 1988;61:211-20.
Bally B. Anesthésie et ORL: Intubation difficile. 5 journée Michel Tassin. bb/itd/Valence/13-05-2000. Centre Hospitalier de Valence.
Bellhouse CP, Dore C. Criteria for estimating likelihood of difficult of tracheal intubation with the McIntosh laryngoscope. Anesth Intens Care. 1988;16:329-37.
Hastings R, Vigil AC. Cervical spine movement during laryngoscopy with the Bullard. McIntosh, and Miller laryngoscopes. Anesthesiology. 1995;82:859-69.
Ramírez-Acosta JA, Torrico-Lara GG, Encinas-Pórcel CM. Índices predictores de vía aérea en pacientes obesos. Rev Mex Anest. 2013;36: 193-201.
Behringer EC. Approaches to managing the upper airway. Anesthesiol Clin North Am. 2002;20:813-32.
Takenaka I, Iwagaki T, Aoyama K, et al. Preoperative evaluation of extension capacity of the occipitoatlantoaxial complex in patients with rheumatoid arthritis. Comparison between the Bellhouse test and a new method, hyomental distance ratio. Anesthesiology. 2006;104:680-5.
Duk-Kyung K, Tae-Kyoon Y, Seong-Hyop K, et al. Diagnostic predictor of difficult laryngoscopy: the hyomental distance ratio. Anesth Analg.. 2009;108:544-8.
Ríos E, Reyes JL. Valor predictivo de las evaluaciones de la vía aérea difícil. Trauma. 2005;8:63-70.
Vasudevan A, Badhe A. Predictors of difficult intubation. A simple approach. The Internet Journal of Anesthesiology 2009;20DOI:10.5580/13aa. Disponible en: http://www.ispub.com/journal/the_internet_journal_of_ anesthesiology.html.
Karkouti K, Keith R. Predicting difficult intubation: a multivariable analysis. Can J Anesth. 2000;47:730-9.
Turkan S, Yesim A. Should we reevaluate the variables for predicting the difficult airway in anesthesiology? Anesth Analg. 2002;94:1340-50.
Cheng F, Vázquez I. Métodos predictivos para una intubación orotraqueal difícil en una población de pacientes del hospital “Dr. Miguel Pérez Carreño”. Rev Ven de Anest. 1998;3:52-8.
Wojtczak JA. Submandibular sonography. Assessment of hyomental distances and ratio, tongue size, and floor of the mouth musculature using portable sonography. J Ultrasound Med. 2012;31:523-8.