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  • Title: Predicting difficult airways using the intubation difficulty scale: a study comparing obese and non-obese patients.
    Author: Lavi R, Segal D, Ziser A.
    Journal: J Clin Anesth; 2009 Jun; 21(4):264-7. PubMed ID: 19502026.
    Abstract:
    STUDY OBJECTIVE: To compare intubation difficulty in obese and non-obese patients by intubation difficulty scale (IDS), intubation duration measurement, and oxygen saturation (SaO(2)) levels. DESIGN: Prospective, controlled study. SETTING: Operating room of a tertiary-care hospital. PATIENTS: 204 ASA physical status I, II, and III adult patients who underwent elective surgery with endotracheal intubation. INTERVENTIONS AND MEASUREMENTS: Preoperative airway parameters, intubation duration, IDS scores, and lowest SaO(2) during intubation were recorded. MAIN RESULTS: IDS scores were higher in the obese group than the non-obese (2.29 +/- 0.45 and 1.26 +/- 0.2, respectively, P = 0.03). Intubation duration was 45.1 +/- 6 sec for obese versus 36.8 +/- 2.6 sec for the non-obese group (P = 0.20). The lowest SaO(2) recorded was 97%, with no difference noted between groups. Mallampati class >or=3 was found to positively predict intubation difficulty scores greater than 5. CONCLUSIONS: Difficult intubation was more prevalent among obese than non-obese patients, but intubation duration and lowest SaO(2) levels during intubation were not. Moreover, the modified Mallampati test was found to be a moderately good (60%) predictor of difficult intubation among obese patients.
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