The Importance of Increased Neck Circumference to Intubation Difficulties in Obese Patients

@article{Gonzalez2008TheIO,
  title={The Importance of Increased Neck Circumference to Intubation Difficulties in Obese Patients},
  author={H. Gonzalez and V. Minville and Khedija Delanoue and M. Mazerolles and D. Concina and O. Fourcade},
  journal={Anesthesia \& Analgesia},
  year={2008},
  volume={106},
  pages={1132-1136}
}
BACKGROUND: Using the intubation difficulty scale (IDS), we sought to confirm that obese patients are more difficult to intubate than lean patients. We assessed classical bedside tests and included neck circumference. METHODS: We prospectively compared the incidence of difficult tracheal intubation in 70 obese [body mass index (BMI) ≥30 kg/m2] and 61 lean patients (BMI <30 kg/m2). The IDS scores, categorized as difficult intubation (IDS >5) or not (IDS ≤5), and the patient data, were compared… Expand
Neck Circumference and Mallampati Test a Predictor for Management Difficult Airway in Obese Patients : A Retrospective Observational Study
Background: Airway management can be challenging in anaesthetic procedures in the obese patients. Preoperative airway evaluation in obese patient requires particular care and attention. In this studyExpand
Neck circumference to thyromental distance ratio: a new predictor of difficult intubation in obese patients.
TLDR
Difficult intubation was more common in obese patients and the NC/TM was a better method for predicting difficultintubation than other established indices. Expand
FREQUENCY OF DIFFICULT INTUBATION IN OBESE PATIENTS WITH NECK CIRCUMFERENCE TO THYROMENTAL DISTANCE RATIO ≥ 5.0
TLDR
The NC/TM ≥5 was found good predictor for difficult intubation in obese patients with neck circumference tothyromental distance ratio (NC/TM) ≥5.0. Expand
The Performance of the Neck Circumference for a Difficult Laryngoscopy in Obese Patients.
TLDR
The NC per se was not a good predictor of a difficult laryngoscopy in obese patients, however the ratio of the NC to the TM and the MMT were factors predicting a difficult gynaecological examination in obesity patients. Expand
Relationship of neck circumference and difficult endotracheal intubation in obese patients
Background and Objectives:  Patient identification with difficult intubation is important in planning anesthetic management and one major factor for difficult intubation in t he obese patients isExpand
Predictive performance of a multivariable difficult intubation model for obese patients
TLDR
The predictive performance of the selected model showed limited benefit for preoperative screening to predict DI among obese patients. Expand
Obstructive Sleep Apnea Is Not a Risk Factor for Difficult Intubation in Morbidly Obese Patients
TLDR
In MO patients undergoing bariatric surgery in the “ramped position,” there was no relationship between the presence and severity of OSA, BMI, or NC and difficulty of intubation or laryngoscopy, as determined by apnea-hypopnea index, gender, and body mass index. Expand
The importance of neck circumference to thyromental distance ratio (NC/TM) as a predictor of difficult intubation in obstructive sleep apnea (OSA) patients
TLDR
The neck circumference to thyromental distance ratio is studied as a new predictor of difficult intubation in obstructive sleep apnea (OSA) patients and comparing it to the formally standard Mallampati score. Expand
Neck circumference to thyromental distance ratio: Is a reliable predictor of difficult intubation in obese patients?
TLDR
NC/TM ratio can be considered as reliable and better bedside screening test for predicting intubation difficulties in obese patients on background of routinely practiced Modified Mallampati Classification. Expand
The performance of neck circumference and other airway assessment tests for the prediction of difficult intubation in obese parturients undergoing cesarean delivery.
TLDR
The neck circumference, the sternomental distance, the modified Mallampati test and the ratio of neck circumference to the sternmental distance show limited performance as screening tests to predict difficult intubation among obese parturients. Expand
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References

SHOWING 1-10 OF 29 REFERENCES
Difficult Tracheal Intubation Is More Common in Obese Than in Lean Patients
TLDR
It is concluded that difficult intubation is more common among obese than nonobese patients and the high risk of desaturation warrants studies to identify new predictors of difficult intubiation in the obese. Expand
Morbid Obesity and Tracheal Intubation
TLDR
It is concluded that obesity alone is not predictive of tracheal intubation difficulties, and large neck circumference and high Mallampati score were the only predictors of potentialintubation problems. Expand
Relationship between difficult tracheal intubation and obstructive sleep apnoea.
TLDR
It is concluded that difficult intubation and OSA are related significantly and share anatomical features which act to reduce the skeletal confines of the tongue. Expand
Value of oropharyngeal Mallampati classification in predicting difficult laryngoscopy among obese patients.
TLDR
It is concluded that obesity which is associated with a disproportionately large base of the tongue, is a predisposing factor for difficult laryngoscopy. Expand
Increased body mass indexper se is not a predictor of difficult laryngoscopy
TLDR
Increased age, male sex, TMJ pathology, Mallampati 3 and 4, a history of obstructive sleep apnea and abnormal upper teeth were associated with a higher incidence of DL and the magnitude of BMI had no influence on difficulty with laryngoscopy. Expand
Prediction of difficult laryngoscopy in obese patients by ultrasound quantification of anterior neck soft tissue *
TLDR
It is concluded that an abundance of pretracheal soft tissue at the level of the vocal cords is a good predictor of difficult laryngoscopy in obese patients. Expand
Tracheal intubation of morbidly obese patients: LMA CTrach vs direct laryngoscopy.
TLDR
It is demonstrated that the CT was an efficient airway device for ventilation and tracheal intubation in case of a difficult airway in morbidly obese patients. Expand
Preoperative Airway Assessment: Predictive Value of a Multivariate Risk Index
TLDR
Improved risk stratification for difficulty with visualization during rigid laryngoscopy (Grade IV) can be obtained by use of a simplified preoperative multivariate airway risk index, with better accuracy compared to oropharyngeal (Mallampati) classification at both low- and high-risk levels. Expand
The Intubation Difficulty Scale (IDS): Proposal and Evaluation of a New Score Characterizing the Complexity of Endotracheal Intubation
TLDR
A quantitative score that can be used to evaluate intubating conditions and techniques with the aim of determining the relative values predictive factors of intubation difficulty and of the techniques used to decrease such difficulties is developed. Expand
Relative risk analysis of factors associated with difficult intubation in obstetric anesthesia.
TLDR
Preoperative airway assessment and potential risk factors for difficult tracheal intubation were recorded in 1,500 patients undergoing emergency and elective cesarean section under general anesthesia and the probability of experiencing a difficult intubations for various combinations of risk factors was determined. Expand
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