دورية أكاديمية
The supraglottic airway device as first line of management in anticipated difficult mask ventilation in the morbidly obese
| العنوان: | The supraglottic airway device as first line of management in anticipated difficult mask ventilation in the morbidly obese |
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| المؤلفون: | Aparna Sinha, Lakshmi Jayaraman, Dinesh Punhani |
| المصدر: | Journal of Anaesthesiology Clinical Pharmacology, Vol 35, Iss 4, Pp 540-545 (2019) |
| بيانات النشر: | Wolters Kluwer Medknow Publications, 2019. |
| سنة النشر: | 2019 |
| المجموعة: | LCC:Anesthesiology LCC:Pharmacy and materia medica |
| مصطلحات موضوعية: | apnea time, body mass index, bariatric, difficult airway, mask ventilation, neck circumference, obese, stopbang, Anesthesiology, RD78.3-87.3, Pharmacy and materia medica, RS1-441 |
| الوصف: | Background and Aims: Supraglottic airway devices (SGAs) are used to rescue difficult and failed mask ventilation (DMV). We aimed to use the SGA as first-line device, prior to obtaining a definitive airway and to find any predictors of difficulty for the same, in the morbidly obese patients. Material and Methods: Obese surgical patients [body mass index (BMI) >35 kg/m2] were investigated. Difficulties with bag mask ventilation (MV) was graded using the following scale: MV-1, one anesthesiologist unassisted could achieve MV and maintain SpO2 >90%; MV-2, one additional anesthesiologist was needed to facilitate MV to achieve SpO2> 90%; MV-3, two additional anesthesiologists were needed for this purpose; and MV-3P, when a supraglottic device was required to ventilate and maintain SpO2more than 90%. Parameters studied were age, gender, neck circumference (NC), BMI, STOPBANG score, and safe apnea time (SAT). Results: Logistic regression was performed for predictors of MV-3P; receiver operating characteristic curve was used to locate the best cut-off. Analysis of 834 morbidly obese patients revealed an incidence of MV 1/2/3/3-P as 16%/38%/27%/19%, respectively. DMV was associated with BMI ≥50 kg/m2, NC ≥49.5 cm, and STOPBANG ≥6; P < 0.001. The mean SAT for a population with mean BMI 48 ± 8 kg/m2 was 256 ± 66 s. The SAT showed inverse relation to BMI and NC. As per our results, the NC was the single most important predictor of MV-3P, with sensitivity 0.62 and specificity 0.85 at best cut-off 49.5 cm; P < 0.001. Conclusion: NC ≥49.5 cm is strongly associated with low SAT and need for SGA to achieve MV. SGA may provide safety for initial management following induction of anesthesia in this patient population. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 0970-9185 |
| Relation: | http://www.joacp.org/article.asp?issn=0970-9185;year=2019;volume=35;issue=4;spage=540;epage=545;aulast=Sinha; https://doaj.org/toc/0970-9185 |
| DOI: | 10.4103/joacp.JOACP_159_19 |
| URL الوصول: | https://doaj.org/article/4ac362af7b594af6b1b062c43b00be7e |
| رقم الأكسشن: | edsdoj.4ac362af7b594af6b1b062c43b00be7e |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 09709185 |
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| DOI: | 10.4103/joacp.JOACP_159_19 |