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Acta médica Grupo Ángeles
versión impresa ISSN 1870-7203
Resumen
ENCINAS PORCEL, Carla Mónica; PORTELA ORTIZ, José Manuel y LEY MARCIAL, Luis Alfonso. Predictive value of airway evaluations in obese patients with difficult intubation. Acta méd. Grupo Ángeles [online]. 2019, vol.17, n.3, pp.211-217. Epub 11-Feb-2022. ISSN 1870-7203.
The management of the airway in obese patients is a challenge for the anesthesiologist.
Objective:
Analyze variables associated with obese patients with difficult intubation.
Material and methods:
62 surgical patients were included obese adults, 8 airway variables were evaluated: Mallampati, tiromentoniana distance, esternomentoniana distance (DEM), oral opening, mandibular protrusion, extension of atlanto-occipital articulation, cervical diameter and obstructive sleep apnea syndrome; in the operating room after the anesthetic induction, orotracheal intubation was performed, classifying the difficulty to intubate by the number of laryngoscopes taking 2 or more attempts as difficult intubation.
Results:
17 (27.4%) patients with difficult airway; 10 (16.1%) of them with obesity grade I, the variable associated to airway difficult was the DEM, presented p = 0.01, RR 0.2 (CI95% 0.07-0.7), sensitivity of 41.1, specificity of 91.1, a positive predictive value (VPP) of 63.6 and a negative predictive value (VPN) of 80.3.
Conclusions:
The degree of obesity and BMI is not directly proportional to a difficult airway, but the D-E-M is the most useful test preoperative at the time of evaluating an airway in obese patients. Those taking an important part in the anesthesiologist skill and experience.
Palabras llave : Difficult airway; difficult intubation; obesity; predictive index.